Provider Demographics
NPI:1285830935
Name:NARAYAN, ARCHANA R (MD)
Entity type:Individual
Prefix:DR
First Name:ARCHANA
Middle Name:R
Last Name:NARAYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 N HAMMES AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8100
Mailing Address - Country:US
Mailing Address - Phone:815-744-2300
Mailing Address - Fax:815-744-9208
Practice Address - Street 1:229 N HAMMES AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8100
Practice Address - Country:US
Practice Address - Phone:815-744-2300
Practice Address - Fax:815-744-9208
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118762207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK39215Medicare PIN