Organization Active NPI

Ravinia Healthcare Inc

  • Adolescent Medicine (Family Medicine) Physician
  • Orland Park, IL
National Provider Identifier
1811126733
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
Legal business name
RAVINIA HEALTHCARE INC
Practice address
15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258
Phone
(847) 215-9200
NPI assigned
Jul 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Lana Moshkovich
Title
CMM, CPC, Cemc
Phone
(847) 904-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X Primary

Addresses

Primary practice location

15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258

Mailing address

15030 S Ravinia Ave Ste 38
Orland Park, IL 60462-3258

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1811126733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE STE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 S RAVINIA AVE STE 38",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623258",
            "telephone_number": "847-215-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVINIA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "MOSHKOVICH",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "CMM, CPC, CEMC",
        "authorized_official_telephone_number": "847-904-7500"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.