Provider Demographics
NPI:1972669109
Name:VAHL, RAYMOND W (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:W
Last Name:VAHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11527 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-2367
Mailing Address - Country:US
Mailing Address - Phone:708-448-7337
Mailing Address - Fax:708-448-7350
Practice Address - Street 1:11527 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-2367
Practice Address - Country:US
Practice Address - Phone:708-448-7337
Practice Address - Fax:708-448-7350
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2011-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL03649377207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology