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Individual

DONALD R. RADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 GREEN BAY RD STE 200, HIGHWOOD, IL 60040-1703
(847) 235-2139
Mailing address
200 GREEN BAY RD STE 200, HIGHWOOD, IL 60040-1703
(847) 235-2139
(847) 615-1697

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036-117225
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1633897
GROUP BCBS
IL
01
207844
MEDICARE GROUP NUMBER
IL
01
45-5547004
GROUP TAX ID
Enumeration date
07/17/2006
Last updated
03/21/2019
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