Provider Demographics
NPI:1114143021
Name:KEDAINIS, RASA LIESIONYTE (MD)
Entity Type:Individual
Prefix:
First Name:RASA
Middle Name:LIESIONYTE
Last Name:KEDAINIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RASA
Other - Middle Name:
Other - Last Name:LIESIONYTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2020 OGDEN AVE
Mailing Address - Street 2:STE 140
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5894
Mailing Address - Country:US
Mailing Address - Phone:630-851-1144
Mailing Address - Fax:
Practice Address - Street 1:2020 OGDEN AVE
Practice Address - Street 2:STE 140
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5894
Practice Address - Country:US
Practice Address - Phone:630-851-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-112385207RN0300X
MO2005014811207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology