Provider Demographics
NPI:1407070329
Name:RAYMOND V JANEVICIUS MD PC
Entity type:Organization
Organization Name:RAYMOND V JANEVICIUS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:V
Authorized Official - Last Name:JANEVICIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-833-1800
Mailing Address - Street 1:360 W BUTTERFIELD RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5068
Mailing Address - Country:US
Mailing Address - Phone:630-833-1800
Mailing Address - Fax:
Practice Address - Street 1:360 W BUTTERFIELD RD
Practice Address - Street 2:SUITE 230
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5068
Practice Address - Country:US
Practice Address - Phone:630-833-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360589082082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215690400OtherACS PROVIDER NUMBER
IL2201474OtherBCBS
IL215690400OtherACS PROVIDER NUMBER
ILC44426Medicare UPIN