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Individual

MR. CHARLES P. RAGONA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C.

Contact information

Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-6212
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-6212

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001155
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
434110
MEDICARE GROUP
01
970024573
RAILROAD MEDICARE
Enumeration date
08/03/2006
Last updated
06/18/2008
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