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Contact Information

MEDA RAGHAVENDRA, MD
2160 S FIRST AVE
(15750 MARIAN DR., HOMER GLEN, IL. 60526)
MAYWOOD, IL60153
 Phone: 708-216-6462
 Fax: 708-216-1249
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for MEDA RAGHAVENDRA · (Male)

NPI Number 1629048962
Status Active
Credentials MD
Entity Individual
Enumeration date 01/26/2006
Last updated 03/04/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 36092881
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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