Individual
DR. KEVIN DAWRAVOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4405 WEAVER PKWY, WARRENVILLE, IL 60555-3269
(630) 352-5300
(630) 352-5595
Mailing address
4405 WEAVER PKWY, WARRENVILLE, IL 60555-3269
(630) 352-5300
(630) 352-5595
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036122919
IL
207RH0000X
Hematology (Internal Medicine) Physician
036122919
IL
207RH0003X
Hematology & Oncology Physician
Primary
036122919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122919
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147128
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
CA4748
MEDICARE RAILROAD PTAN (GROUP)
IL
01
—
P01095279
MEDICARE RAILROAD PTAN (INDIVIDUAL)
IL
Enumeration date
08/06/2008
Last updated
11/21/2017
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