Provider Demographics
NPI:1154530798
Name:SEMERDJIAN, RONALD ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ARTHUR
Last Name:SEMERDJIAN
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 1:2507 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1336
Mailing Address - Country:US
Mailing Address - Phone:847-251-8669
Mailing Address - Fax:847-251-4455
Practice Address - Street 1:2507 KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1336
Practice Address - Country:US
Practice Address - Phone:847-251-8669
Practice Address - Fax:847-251-4455
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC41193Medicare UPIN