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General NPI Number Information
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NPI Number | 1396930590
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Entity Type | Individual
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Provider Name | RANILO JOHN RABACAL MD
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Gender | Male
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 635 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60654-4618
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Country | US
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Telephone | 312-694-2273
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Fax | 312-694-2129
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Provider Business Mailing Address
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Address Line | 635 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60654-4618
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Country | US
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Telephone | 312-694-2273
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Fax | 312-694-2129
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301090735
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-124828
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License Number State | IL
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