# RAVINIA HEALTHCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811126733
- **Authorized official:** LANA MOSHKOVICH (CMM, CPC, CEMC)
- **Authorized official phone:** (847) 904-7500

## Contact information

- **Practice address:** 15030 S RAVINIA AVE STE 38, ORLAND PARK, IL 60462-3258
- **Practice address phone:** (847) 215-9200
- **Mailing address:** 15030 S RAVINIA AVE STE 38, ORLAND PARK, IL 60462-3258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2009
- **Last updated:** 07/13/2009