Provider Demographics
NPI:1508048414
Name:ROUEEN RAFEYAN MD LTD
Entity type:Organization
Organization Name:ROUEEN RAFEYAN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROUEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFEYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-433-0057
Mailing Address - Street 1:1140 N MILWAUKEE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-4096
Mailing Address - Country:US
Mailing Address - Phone:773-536-2700
Mailing Address - Fax:773-536-2703
Practice Address - Street 1:1140 N MILWAUKEE AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-4096
Practice Address - Country:US
Practice Address - Phone:773-536-2700
Practice Address - Fax:773-536-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360891522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210680Medicare PIN