Individual
RAKA CHINDAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-5187
Mailing address
3159 S NORMAL AVE UNIT 1F, CHICAGO, IL 60616-3109
(405) 922-1655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
125.084061
IL
Other
Enumeration date
03/25/2024
Last updated
06/18/2024
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