Provider Demographics
NPI:1548331036
Name:POLLAK, RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:POLLAK
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 1:8852 KOSTNER TER
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1838
Mailing Address - Country:US
Mailing Address - Phone:847-675-1511
Mailing Address - Fax:847-745-0139
Practice Address - Street 1:4240 DEMPSTER ST
Practice Address - Street 2:SUITE F
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-2070
Practice Address - Country:US
Practice Address - Phone:847-673-7773
Practice Address - Fax:847-673-7772
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057804208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery