Individual
DR. AVTAR K RAZDAN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
475 BROWN BLVD, SUITE 102, BOURBONNAIS, IL 60914-2325
(815) 939-0003
(815) 935-4908
Mailing address
475 BROWN BLVD, SUITE 102, BOURBONNAIS, IL 60914-2325
(815) 939-0003
(815) 935-4908
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036048822
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048822
—
IL
01
—
04607499
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/23/2005
Last updated
09/28/2012
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