Organization
BOB RADY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J RADY CRNA (OWNER)
(708) 614-7588
Entity
Organization
Contact information
Practice address
17954 HIGHLAND AVE, TINLEY PARK, IL 60477-4269
(708) 614-7588
(708) 614-6588
Mailing address
17954 HIGHLAND AVE, TINLEY PARK, IL 60477-4269
(708) 614-7588
(708) 614-6588
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
252430
MEDICARE GRP
IN
Enumeration date
01/05/2007
Last updated
01/09/2008
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