MEDICARE: NICHOLAS RAUH MD

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
1	2086S0105X	Surgery of the Hand (Surgery) Physician	4301511556	MI

General Provider Information

NPI Number	:	1912468448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS RAUH MD

Provider Business Mailing Address
First Line	:	22151 MOROSS RD STE 212
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48236-2177
Country	:	US
Telephone Number	:	313-343-4867
Fax Number	:	313-343-3280

Provider Business Practice Location Address
First Line	:	1200 S YORK ST STE 3200
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5637
Country	:	US
Telephone Number	:	630-359-6888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	07/20/2025

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