Provider Demographics
NPI:1215107123
Name:PHILLIPS, ARNOLD GILBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:GILBERT
Last Name:PHILLIPS
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 1:710 E OGDEN AVE
Mailing Address - Street 2:450
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8602
Mailing Address - Country:US
Mailing Address - Phone:630-328-0016
Mailing Address - Fax:
Practice Address - Street 1:710 E OGDEN AVE
Practice Address - Street 2:450
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8602
Practice Address - Country:US
Practice Address - Phone:630-328-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36076706207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine