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General NPI Number Information
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NPI Number | 1548331036
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Entity Type | Individual
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Provider Name | RAYMOND POLLAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 4240 DEMPSTER ST SUITE F
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City | SKOKIE
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State | IL
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Zip | 60076-2070
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Country | US
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Telephone | 847-673-7773
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Fax | 847-673-7772
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Provider Business Mailing Address
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Address Line | 8852 KOSTNER TER
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City | SKOKIE
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State | IL
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Zip | 60076-1838
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Country | US
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Telephone | 847-675-1511
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Fax | 847-745-0139
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036057804
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036057804
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License Number State | IL
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