Provider Demographics
NPI:1578514188
Name:KAWASAKI, RAYMOND NOBUSHIGE (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:NOBUSHIGE
Last Name:KAWASAKI
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 1:880 W CENTRAL RD STE 7100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2379
Mailing Address - Country:US
Mailing Address - Phone:847-618-2500
Mailing Address - Fax:847-392-7834
Practice Address - Street 1:880 W CENTRAL RD STE 7100
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2379
Practice Address - Country:US
Practice Address - Phone:847-618-2500
Practice Address - Fax:847-392-7834
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090477207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090477Medicaid
060046331OtherRAILROAD MEDICARE
ILK05395Medicare ID - Type UnspecifiedLOCALE H16
060046331OtherRAILROAD MEDICARE
G15016Medicare UPIN
ILK05762Medicare ID - Type UnspecifiedH99