Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Prutha R Rajyaguru, PA-C

Individual provider Physician Assistant · NPI 1306396700

Prutha R Rajyaguru, PA-C is a Physician Assistant in Palos Heights, Illinois. Qualified in 2016, 10 years ago. Accepts Medicare assignment. Licensed in California, Illinois and Indiana.

Years since qualifying
10
Licensed in
CA, IL, IN
In the registry since
2016
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12255 S 80th Ave Ste 203
Palos Heights, IL 60463-1284
Phone: (708) 827-2021
Fax: (708) 827-2241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085008524 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 53876 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 10004020A (IN)

Record details

NPI number1306396700
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 10, 2016
Last updated in NPPESJune 5, 2025
Certification dateJune 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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