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Organization
RAFA S ADI MD LTD
Active
Organization
RAFA S ADI MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFA ADI M.D. (OWNER)
(847) 362-5344
Entity
Organization
Contact information
Practice address
1870 W WINCHESTER RD, SUITE 246, LIBERTYVILLE, IL 60048-5358
(847) 362-5344
(847) 362-5332
Mailing address
1870 W WINCHESTER RD, SUITE 246, LIBERTYVILLE, IL 60048-5358
(847) 362-5344
(847) 362-5332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04921389
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/28/2007
Last updated
08/22/2020
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