Provider Demographics
NPI:1659804417
Name:NATARAJAN, SAMEERA (MD)
Entity type:Individual
Prefix:DR
First Name:SAMEERA
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12632 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1428
Mailing Address - Country:US
Mailing Address - Phone:708-587-0000
Mailing Address - Fax:708-623-7628
Practice Address - Street 1:17800 KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2029
Practice Address - Country:US
Practice Address - Phone:708-799-8000
Practice Address - Fax:708-623-7628
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.171497207R00000X
MO2020021223208M00000X, 207R00000X
IL336.126650207R00000X
TN66858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200086998Medicaid