Provider Demographics
NPI:1598893208
Name:RAO, SUNILA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUNILA
Middle Name:M
Last Name:RAO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SUNILA
Other - Middle Name:M
Other - Last Name:HAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-6002
Mailing Address - Country:US
Mailing Address - Phone:847-791-9185
Mailing Address - Fax:
Practice Address - Street 1:720 OSTERMAN AVE STE 303
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4339
Practice Address - Country:US
Practice Address - Phone:847-791-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006663103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232567OtherBCBS OF ILLINOIS PIN