Provider Demographics
NPI:1467794883
Name:BIELSKI, RAGINI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAGINI
Middle Name:
Last Name:BIELSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAGINI
Other - Middle Name:
Other - Last Name:BHADULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-3242
Mailing Address - Fax:708-216-3375
Practice Address - Street 1:10215 BROADWAY STE 205
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8001
Practice Address - Country:US
Practice Address - Phone:219-769-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1467794883207R00000X, 208000000X
IL036143901208M00000X
IN01082142A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300028285Medicaid