Provider Demographics
NPI:1710943220
Name:RAFF, LESTER J (MD)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:J
Last Name:RAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2225 ENTERPRISE DR
Mailing Address - Street 2:SUITE 2511
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5814
Mailing Address - Country:US
Mailing Address - Phone:708-486-0076
Mailing Address - Fax:708-486-0080
Practice Address - Street 1:2225 ENTERPRISE DR
Practice Address - Street 2:SUITE 2511
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5814
Practice Address - Country:US
Practice Address - Phone:708-486-0076
Practice Address - Fax:708-486-0080
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036060672174400000X
IL036-060672207ZP0105X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No174400000XOther Service ProvidersSpecialist
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00299126OtherRAILROAD MEDICARE
IL036060672Medicaid
ILE18616Medicare UPIN
K21665Medicare PIN
216096004Medicare PIN