Provider Demographics
NPI:1598929853
Name:GOVINDARAJAN, HEMAMAHESWARI (MD)
Entity type:Individual
Prefix:
First Name:HEMAMAHESWARI
Middle Name:
Last Name:GOVINDARAJAN
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 1:7 BLANCHARD CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2038
Mailing Address - Country:US
Mailing Address - Phone:630-682-0500
Mailing Address - Fax:630-682-1078
Practice Address - Street 1:7 BLANCHARD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2038
Practice Address - Country:US
Practice Address - Phone:630-682-0500
Practice Address - Fax:630-682-1078
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121224207P00000X
IL036-121224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036121224Medicaid
ILIL5686082Medicare UPIN
ILPAYEE 2Medicaid