DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JITHINRAJ EDAKKANAMBETH VARAYIL, MD

Deactivated

DR. JITHINRAJ EDAKKANAMBETH VARAYIL, MD is a Family Medicine healthcare provider located in ROCKFORD, Illinois. NPI 1033591847 is deactivated in the NPPES registry. Verify at CMS.

Family Medicine · ROCKFORD, IL

This NPI has been deactivated. The record was deactivated on July 27, 2018. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1033591847
Provider Type
Individual
Gender
Male
NPI Issued
Jun 29, 2015 (3.0767123287671 yrs)
Last Updated
Sep 27, 2021
Deactivated
Jul 27, 2018
Licenses
125-067838 (IL)
125-067838 (IL)
69874 (MN)

Practice Information

Address
1200 W STATE ST
ROCKFORD, IL, 61102
Browse IL providers · Browse ZIP 61102
Phone
8154901600
Fax
8154901881
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine

Other Family Medicine Providers in ROCKFORD, IL

Name Credential NPI
DR. DIANA ELIZABETH ALANIS MD 1922007418
DR. MITCHELL S KING MD 1225038276
DR. THOMAS M SCHILLER MD 1104827641
DR. MICHAEL JAMES POLIZZOTTO M.D. 1871595371
SYED M MOHIUDDIN MD 1144216243
DR. STEVEN D DIAMOND MD 1861481244
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.