Basic Information
Provider Information
NPI: 1720053663
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAY
FirstName: ASOK
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1730 PARK ST
Address2: SUITE 101
City: NAPERVILLE
State: IL
PostalCode: 605632688
CountryCode: US
TelephoneNumber: 6307180200
FaxNumber: 6307180900
Practice Location
Address1: 3231 EUCLID AVE
Address2:  
City: BERWYN
State: IL
PostalCode: 604023471
CountryCode: US
TelephoneNumber: 7084841530
FaxNumber: 7087881571
Other Information
ProviderEnumerationDate: 02/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X ILY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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