Provider Demographics
NPI:1699594150
Name:RAYGOZA, ADRIAN IGNACIO (MPH)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:IGNACIO
Last Name:RAYGOZA
Suffix:
Gender:M
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1566
Mailing Address - Country:US
Mailing Address - Phone:630-550-3036
Mailing Address - Fax:
Practice Address - Street 1:511 E SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1566
Practice Address - Country:US
Practice Address - Phone:630-550-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL39013175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist