Individual
RAVI GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 JORIE BLVD, SUITE 186, OAK BROOK, IL 60523-2213
(630) 954-6700
Mailing address
900 JORIE BLVD, SUITE 186, OAK BROOK, IL 60523-2213
(630) 954-6700
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
036098555
IL
208M00000X
Hospitalist Physician
Primary
036098555
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098555
—
IL
01
—
F400314203
MEDICARE PTAN
—
01
—
L87790
MEDICARE PIN - 645650
IL
Enumeration date
06/12/2006
Last updated
08/10/2017
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