Provider Demographics
NPI:1316988231
Name:ARANA, ENRIQUE A (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:A
Last Name:ARANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5801 N SHERIDAN RD 18A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3870
Mailing Address - Country:US
Mailing Address - Phone:773-816-2007
Mailing Address - Fax:773-334-4931
Practice Address - Street 1:5801 N SHERIDAN RD 18A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3870
Practice Address - Country:US
Practice Address - Phone:773-816-2007
Practice Address - Fax:773-334-4931
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2020-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-065896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC42794Medicare UPIN