Ravinia Medical LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RAVINIA MEDICAL LTD

Practice address

9641 W 153Rd St
Suite 48
Orland Park, IL 60462-3775

Phone

(708) 403-0431

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Rodolfo J Mejicano, MD

Title

Owner / Physician

Phone

(708) 403-0431

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1356397806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9641 W 153RD ST",
            "address_2": "SUITE 48",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9641 W 153RD ST",
            "address_2": "SUITE 48",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623775",
            "telephone_number": "708-403-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVINIA MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "MEJICANO",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "708-403-0431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001628037",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anni Rasmussen, LCPC, CADC
• Angela Ratajczak
• Edward I Ratkovich, DPM
• Adam Raudebaugh, DMD
• Ravinia Healthcare Inc
• Atiya Razi, BCBA
• Rci (WRS), LLC
• Jacqueline Grace Rea, PHD, ABPP-CN
• Peter Redden
• Luis Jacinto Redondo, M.D.

• Internal Medicine Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.