Individual
GENENE RADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 W WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-1370
(217) 366-5348
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1372
(217) 366-5348
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036-115968
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115968
—
IL
01
—
CA2264
RR GROUP
IL
01
—
P00413138
RR INDIVIDUAL
IL
Enumeration date
07/05/2006
Last updated
01/05/2022
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