Provider Demographics
NPI:1811156516
Name:RALPH N DADO JR MD
Entity type:Organization
Organization Name:RALPH N DADO JR MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:DADO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:708-425-7088
Mailing Address - Street 1:9621 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:708-425-7088
Mailing Address - Fax:708-425-8882
Practice Address - Street 1:9621 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:708-425-7088
Practice Address - Fax:708-425-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11473835332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0465150001Medicare NSC