Dr Donald Raden MD LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

36117225 Issued in IL

Legal business name

DR DONALD RADEN MD LLC

Practice address

900 North Shore Dr
Ste 120
Lake Bluff, IL 60044-2243

Phone

(855) 377-2336

Fax

(847) 615-1697

NPI assigned

Jun 22, 2012

Organization subpart

No

Name

Dr. Donald Raden, MD

Title

Ceo

Phone

(855) 377-2336

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2012.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1326301482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NORTH SHORE DR",
            "address_2": "STE 120",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442243",
            "telephone_number": "855-377-2336",
            "fax_number": "847-615-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NORTH SHORE DR",
            "address_2": "STE 120",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442243",
            "telephone_number": "855-377-2336",
            "fax_number": "847-615-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DONALD RADEN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "RADEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-377-2336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "36117225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.