Individual
BAO-LAN RAIKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 S GREENLEAF ST STE E, GURNEE, IL 60031-3398
(800) 991-6117
(888) 812-8191
Mailing address
3820 NORTHDALE BLVD STE 201, TAMPA, FL 33624-1893
(800) 991-6117
(888) 812-8191
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
39327-20
IL
208600000X
Surgery Physician
35479
MN
208600000X
Surgery Physician
39327
WI
208600000X
Surgery Physician
Primary
39327-20
IL
208600000X
Surgery Physician
A69461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841308830
—
WI
Enumeration date
08/29/2006
Last updated
10/30/2025
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