Donald R. Raden, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036-117225 Issued in IL

Practice address

200 Green Bay Rd Ste 200
Highwood, IL 60040-1703

Phone

(847) 235-2139

NPI assigned

Jul 17, 2006

Last updated

Mar 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 15, 2015 through Mar 15, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1083632384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GREEN BAY RD STE 200",
            "city": "HIGHWOOD",
            "state": "IL",
            "postal_code": "600401703",
            "telephone_number": "847-235-2139",
            "fax_number": "847-615-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREEN BAY RD STE 200",
            "city": "HIGHWOOD",
            "state": "IL",
            "postal_code": "600401703",
            "telephone_number": "847-235-2139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 North Shore Dr",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Lake Bluff",
            "state": "IL",
            "postal_code": "600442243",
            "country_code": "US",
            "telephone_number": "855-377-2336 x1",
            "fax_number": "847-615-1697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADEN",
        "first_name": "DONALD",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-117225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID",
            "identifier": "45-5547004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "207844",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "1633897",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatry Physician in Highwood, IL
• Providers in Highwood, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.