Individual
DR. STACY M. RAVIV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 CENTRAL ST STE 615, EVANSTON, IL 60201-1779
(847) 570-2714
(847) 733-5109
Mailing address
1000 CENTRAL ST STE 615, EVANSTON, IL 60201-1779
(847) 570-2714
(847) 733-5109
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036113373
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036113373
IL
207RP1001X
Pulmonary Disease Physician
Primary
036-113373
IL
Other
Enumeration date
10/10/2006
Last updated
02/16/2021
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