Individual
RAVI VASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 695-6868
Mailing address
601 E 15TH ST, AUSTIN, TX 78701-1930
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036145035
IL
2085R0202X
Diagnostic Radiology Physician
BP10050058
TX
Other
Enumeration date
06/02/2014
Last updated
04/18/2019
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