Healthcare Provider Details

I. General information

NPI: 1912468448
Provider Name (Legal Business Name): NICHOLAS RAUH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/20/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S YORK ST STE 3200
ELMHURST IL
60126-5637
US

IV. Provider business mailing address

22151 MOROSS RD STE 212
DETROIT MI
48236-2177
US

V. Phone/Fax

Practice location:
  • Phone: 630-359-6888
  • Fax:
Mailing address:
  • Phone: 313-343-4867
  • Fax: 313-343-3280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number4301511556
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: