Provider Demographics
NPI:1124036769
Name:RAIKER, KRISHNAKANT (MD)
Entity Type:Individual
Prefix:MR
First Name:KRISHNAKANT
Middle Name:
Last Name:RAIKER
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 1:9038 COLUMBIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2905
Mailing Address - Country:US
Mailing Address - Phone:219-836-8106
Mailing Address - Fax:219-836-5774
Practice Address - Street 1:9038 COLUMBIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2905
Practice Address - Country:US
Practice Address - Phone:219-836-8106
Practice Address - Fax:219-836-5774
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042561207R00000X, 207RC0000X
IL036097164207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000095730OtherANTHEM
IN5926543OtherAETNA
IN110192685OtherRAILROAD MEDICARE
IL90001294OtherBC/BS ILLINOIS
IN200083680Medicaid
IL90001294OtherBC/BS ILLINOIS
IN200083680Medicaid
IN237870BMedicare PIN