Provider Demographics
NPI:1619193141
Name:DOSHI, RAMESH H (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:H
Last Name:DOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13011 S 104TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1506
Mailing Address - Country:US
Mailing Address - Phone:708-448-3300
Mailing Address - Fax:708-448-6972
Practice Address - Street 1:13011 S 104TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1506
Practice Address - Country:US
Practice Address - Phone:708-448-3300
Practice Address - Fax:708-448-6972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0502862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01623882OtherBCBS
IL036050286Medicaid
IL997310OtherMEDICARE ID
IL036050286Medicaid
ILD12858Medicare UPIN
ILK06146Medicare PIN