Individual
DR. GREGORY S. RAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6500 N CLARK ST, CHICAGO, IL 60626-4097
(773) 388-1600
(708) 364-7080
Mailing address
6500 N CLARK ST, CHICAGO, IL 60626-4097
(773) 388-1600
(708) 364-7080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.113393
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630151
BCBS PROVIDER GROUP #
IL
05
—
036113393
—
IL
01
—
14D0991123
CLIA #
IL
01
—
705600
MEDICARE GROUP #
IL
01
—
7400752
AETNA PROVIDER ID#
IL
Enumeration date
07/27/2006
Last updated
06/28/2022
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