| Ravenco Inc | |
|
5115 N Ravenswood Ave Fl 2 Chicago IL 60640-2712 | |
| (312) 925-7800 | |
| Not Available |
| Full Name | Ravenco Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5115 N Ravenswood Ave Fl 2, Chicago, Illinois |
| Authorized Official Name and Position | Ronald E Pajak (OWNER, LCSW) |
| Authorized Official Contact | 3129257800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ravenco Inc 5115 N Ravenswood Ave Fl 2 Chicago IL 60640-2712 Ph: (312) 925-7800 | Ravenco Inc 5115 N Ravenswood Ave Fl 2 Chicago IL 60640-2712 Ph: (312) 925-7800 |
| NPI Number | 1528791845 |
|---|---|
| Provider Enumeration Date | 07/05/2022 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Medicare PECOS PAC ID | 6608257597 |
|---|---|
| Medicare Enrollment ID | O20220725000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528791845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ronald Pajak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871867044 PECOS PAC ID: 9234510124 Enrollment ID: I20220725000616 |
| Provider Name | Lauren Ashley Caccamo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366937583 PECOS PAC ID: 4385027937 Enrollment ID: I20220816000516 |
| Provider Name | Jodi Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316397763 PECOS PAC ID: 6709938905 Enrollment ID: I20220816003548 |
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