Individual
DR. RADA IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5600 W ADDISON ST, SUITE 304, CHICAGO, IL 60634-4401
(773) 481-1570
(773) 481-0547
Mailing address
5600 W ADDISON ST, SUITE 304, CHICAGO, IL 60634-4401
(773) 481-1570
(773) 481-0547
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01085124A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036089071
IL
207RP1001X
Pulmonary Disease Physician
036089071
IL
207RP1001X
Pulmonary Disease Physician
M-2341
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089071
—
IL
01
—
04645032
ECFMG
IL
Enumeration date
07/07/2005
Last updated
10/31/2022
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