Provider Demographics
NPI:1013928712
Name:POPLI, RAMAN I (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:I
Last Name:POPLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:145 S VIRGINIA ST STE C
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7226
Mailing Address - Country:US
Mailing Address - Phone:815-363-6055
Mailing Address - Fax:815-363-6150
Practice Address - Street 1:145 S VIRGINIA ST STE C
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7226
Practice Address - Country:US
Practice Address - Phone:815-363-6055
Practice Address - Fax:815-363-6150
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36104035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36104035Medicaid
H32985Medicare UPIN
IL36104035Medicaid