Ivanov, Rada

Ivanov, Rada is an individual health care provider with primary practice located at 5600 W Addison St Suite 304, Chicago IL 60634-4401. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Ivanov, Rada can be contacted via phone (773) 481-1570.

Contact Information

Primary practice address
5600 W Addison St Suite 304 Chicago IL 60634-4401
Phone: (773) 481-1570
Fax: (773) 481-0547
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 036089071 Illinois
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 036089071 Illinois
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X M-2341 Guam
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 01085124A Indiana

Profile Details

NPI number 1790782613
LBN Legal business name Ivanov, Rada
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Oct 31st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790782613 NPPES
Illinois MEDICAID 036089071
Illinois Other 04645032

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