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NPI Code Detail

MEDICARE: RADIAL HEALTH SC

MEDICARE: RADIAL HEALTH SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician042007901IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14921788OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1215954185
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIAL HEALTH SC
Provider Business Mailing Address
First Line : 401 N MICHIGAN AVE STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4264
Country : US
Telephone Number : 847-289-5727
Fax Number : 847-888-5469
Provider Business Practice Location Address
First Line : 401 N MICHIGAN AVE STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4264
Country : US
Telephone Number : 847-289-5727
Fax Number : 847-888-5469
Authorized Official
Title or Position : CEO
Name : AMISH PATEL
Credential :
Telephone Number : 816-728-3674
Provider Enumeration Date : 07/16/2006
Last Update Date : 06/12/2024

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Directions to “RADIAL HEALTH SC ” Practice Location

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