Provider Demographics
NPI:1760663322
Name:DR. DAVID RAKOFSKY PC
Entity type:Organization
Organization Name:DR. DAVID RAKOFSKY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-735-3034
Mailing Address - Street 1:1950 N STEMMONS FWY #5010 LOCKBOX 844274
Mailing Address - Street 2:LOCKBOX 844274
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3199
Mailing Address - Country:US
Mailing Address - Phone:312-384-1940
Mailing Address - Fax:773-423-8444
Practice Address - Street 1:1011 W WELLINGTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7187
Practice Address - Country:US
Practice Address - Phone:312-384-1940
Practice Address - Fax:773-423-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006828261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center