Provider Demographics
NPI:1811045842
Name:KEWALRAMANI, ANITA LALL (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:LALL
Last Name:KEWALRAMANI
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 1:1306 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-2703
Mailing Address - Country:US
Mailing Address - Phone:630-810-0900
Mailing Address - Fax:630-810-0937
Practice Address - Street 1:1306 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561
Practice Address - Country:US
Practice Address - Phone:630-810-0900
Practice Address - Fax:630-810-0937
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96602208000000X
IL036.1184332080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics