Provider Demographics
NPI:1407803794
Name:ADLAKA, RAJIVE K (MD)
Entity Type:Individual
Prefix:
First Name:RAJIVE
Middle Name:K
Last Name:ADLAKA
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:PO BOX 783
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375
Mailing Address - Country:US
Mailing Address - Phone:219-864-9494
Mailing Address - Fax:219-864-9595
Practice Address - Street 1:7280 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-9526
Practice Address - Country:US
Practice Address - Phone:219-864-9494
Practice Address - Fax:219-864-9595
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049448A207L00000X, 208VP0000X
IL036103384207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00319488OtherRAILROAD MEDICARE
INP00649075OtherRAILROAD MEDICARE
ILP00319488OtherRAILROAD MEDICARE
IN237300AMedicare PIN
ILK28258Medicare PIN