Provider Demographics
NPI:1740231364
Name:CHEPURI, NEERAJ B (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERAJ
Middle Name:B
Last Name:CHEPURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4201 W MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8409
Mailing Address - Country:US
Mailing Address - Phone:815-334-5566
Mailing Address - Fax:815-759-4008
Practice Address - Street 1:4201 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8409
Practice Address - Country:US
Practice Address - Phone:815-334-5566
Practice Address - Fax:815-759-4008
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN445262085N0700X
WI810582085R0202X
IL0361354332085R0202X
IL036-1354332085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1621107OtherAMERICA'S PPO
MN316533700Medicaid
MN1604293OtherMEDICA
MN1031005OtherPREFERRED ONE
ND23937OtherBLUE CROSS
MN9227750OtherDAKOTA CARE
MN300131148OtherRAILROAD MEDICARE WI
MNHP35296OtherHEALTHPARTNERS
IA0563353Medicaid
MN141900OtherUCARE
WI34351000Medicaid
MN300131147OtherRAILROAD MEDICARE MN
MN62G37CHOtherBLUE CROSS
MN252816OtherMIDLANDS CHOICE INC
MN316533700Medicaid
MN62G37CHOtherBLUE CROSS
MN300002895Medicare PIN
ND23937Medicare PIN
WI003304070Medicare PIN
MN300003565Medicare PIN
IA0563353Medicaid
WI34351000Medicaid