Individual
BADAL RAVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11104 PARKVIEW CIRCLE DR, ENTRANCE 11, SUITE 330, FORT WAYNE, IN 46845-1730
(260) 494-3484
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01061143A
IN
207RN0300X
Nephrology Physician
35.120042
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLIED
BCBS
IN
01
—
P00334010
RAILROAD MEDICARE
IN
Enumeration date
05/12/2006
Last updated
11/10/2022
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