Individual
ADAM RAUDEBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9443 W 144TH PLACE, ORLAND PARK, IL 60462-2543
(708) 403-9848
Mailing address
180 N ADA ST APT 514, CHICAGO, IL 60607-1542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
319.023219
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
319.023219
DENTAL LICENSE
IL
Enumeration date
05/31/2022
Last updated
11/28/2023
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