Active NPI
Michael Kevin Rakotz, MD
- Family Medicine Physician
- Evanston, IL
National Provider Identifier
1902934532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036117580
- Practice address
- 1704 Maple Ave
Suite 200
Evanston, IL 60201-3134 - Phone
- (312) 694-2010
- Fax
- (312) 694-2020
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036117580 | IL | Primary |
Addresses
Primary practice location
1704 Maple Ave
Suite 200
Evanston, IL 60201-3134
Mailing address
1704 Maple Ave
Suite 200
Evanston, IL 60201-3134
Phone (312) 694-2010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01362441 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036117580 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Health Initiatives Colorado | Past | Accepting new patients | |
| Longmont United Hospital | Past | Accepting new patients | |
| Northwestern Memorial Physicians Group | Past | Accepting new patients | |
| Catholic Health Initiatives Colorado | Family Medicine | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Orthopaedic Surgery Physician
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-
- General Acute Care Hospital
- Longmont, CO
- NPI 1366465866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1902934532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 MAPLE AVE",
"address_2": "SUITE 200",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602013134",
"telephone_number": "312-694-2010",
"fax_number": "312-694-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 MAPLE AVE",
"address_2": "SUITE 200",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602013134",
"telephone_number": "312-694-2010",
"fax_number": "312-694-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAKOTZ",
"first_name": "MICHAEL",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036117580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01362441",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.