Meda Raghavendra, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

36092881 Issued in IL

Practice address

2160 S First Ave
(15750 Marian Dr., Homer Glen, Il. 60526)
Maywood, IL 60153

Phone

(708) 216-6462

Fax

(708) 216-1249

NPI assigned

Jan 26, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1629048962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(15750 MARIAN DR., HOMER GLEN, IL. 60526)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-6462",
            "fax_number": "708-216-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(15750 MARIAN DR., HOMER GLEN, IL. 60526)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-6462",
            "fax_number": "708-216-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVENDRA",
        "first_name": "MEDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "36092881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Rabbat, MD
• Mark Rabbat, MD
• Allison R Radice, PHD
• Anne Marie Joseph Radzik
• Michael JM Raffin, PH.D.
• John R. Ragonese, PT
• Sarah Rahman, M.D.
• Lily Rajaee
• Prabha Rajan, MD
• Amritha Madelyn Rajasekhar

• Interventional Pain Medicine Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.