NPIMap

Organization Active NPI

Rad Gharavi MD PC

  • Psychiatry Physician
  • Oak Park, IL
National Provider Identifier
1144495144
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
36-103322 Issued in IL
Legal business name
RAD GHARAVI MD PC
Practice address
6551 North Ave
Oak Park, IL 60302-1020
Phone
(708) 790-5200
Fax
(708) 524-2104
NPI assigned
Apr 29, 2008
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Rad Gharavi, M.D.NPI 1518078732
Title
President
Phone
(708) 790-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 36-103322 IL Primary

Addresses

Primary practice location

6551 North Ave
Oak Park, IL 60302-1020

Mailing address

6551 North Ave
Oak Park, IL 60302-1020
Phone (708) 790-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080905000603 IL Part B Supplier - Clinic/Group Practice 0547336091 Receives reassigned benefits from 6 practitioners
Practice locations: Forrest Park, IL; Oak Park, IL
O20200720000972 FL Part B Supplier - Clinic/Group Practice 0547336091 Receives reassigned benefits from 4 practitioners
Practice locations: Lutz, FL

National Provider Directory

National Provider Directory
Tax ID family
Rad Gharavi MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1010 Lake St
Ste 100
Oak Park, IL 60301
Phone (708) 790-5200

1010 Lake St
Ste 602
Oak Park, IL 60301
Phone (708) 790-5200

6551 North Ave
Oak Park, IL 60302
Phone (708) 445-0480

7115 North Ave
#274
Oak Park, IL 60302

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1144495144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021020",
            "telephone_number": "708-790-5200",
            "fax_number": "708-524-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021020",
            "telephone_number": "708-790-5200",
            "fax_number": "708-524-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAD GHARAVI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "GHARAVI",
        "authorized_official_first_name": "RAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-790-5200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "36-103322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.