Individual
DR. BRIAN P RAGONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 ESSINGTON RD STE C, JOLIET, IL 60435-8416
(815) 729-0129
(815) 729-1643
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036069543
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069543
—
IL
01
—
09919564
BLUECROSSBLUESHIELD OF IL
IL
01
—
110097513
RAILROAD MEDICARE
IL
Enumeration date
06/23/2005
Last updated
08/17/2023
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