Provider Demographics
NPI:1578837993
Name:RAO, HARSIMRIT (PA-C)
Entity Type:Individual
Prefix:
First Name:HARSIMRIT
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SIMRIT
Other - Middle Name:
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:441 E ERIE ST
Mailing Address - Street 2:APARTMENT NUMBER 4209
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4446
Mailing Address - Country:US
Mailing Address - Phone:310-384-9022
Mailing Address - Fax:
Practice Address - Street 1:200 N MICHIGAN AVE
Practice Address - Street 2:SUITE NUMBER 607
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5909
Practice Address - Country:US
Practice Address - Phone:310-384-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003736363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical