Provider Demographics
NPI:1487800249
Name:JOHN, RAKESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:
Last Name:JOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 FRANCE AVE S
Mailing Address - Street 2:SLEEP CENTER, SUITE 103
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2129
Mailing Address - Country:US
Mailing Address - Phone:952-924-5053
Mailing Address - Fax:952-924-5994
Practice Address - Street 1:6363 FRANCE AVE S
Practice Address - Street 2:SLEEP CENTER, SUITE 103
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2129
Practice Address - Country:US
Practice Address - Phone:952-924-5053
Practice Address - Fax:952-924-5994
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250540492084P0800X
MN549412084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MN290000750Medicare PIN