Individual
DR. DAVID MICHAEL COMP RAKOFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1011 W WELLINGTON AVE # 210, CHICAGO, IL 60657-4325
(312) 384-1940
(773) 423-8444
Mailing address
1011 W WELLINGTON AVE # 210, CHICAGO, IL 60657-4325
(312) 384-1940
(773) 423-8444
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006828
IL
103TC0700X
Clinical Psychologist
20041938A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353109
ANTHEM BCBS
IN
05
—
200345070
—
IN
01
—
IL5309001
MEDICARE PTAN
IL
Enumeration date
08/15/2005
Last updated
09/10/2020
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