Provider Demographics
NPI:1366618381
Name:MOHAN C AIRAN MD SC
Entity type:Organization
Organization Name:MOHAN C AIRAN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:AIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-268-0132
Mailing Address - Street 1:2340 S HIGHLAND AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5371
Mailing Address - Country:US
Mailing Address - Phone:630-268-0132
Mailing Address - Fax:630-268-0153
Practice Address - Street 1:2340 S HIGHLAND AVE
Practice Address - Street 2:STE 250
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5371
Practice Address - Country:US
Practice Address - Phone:630-268-0132
Practice Address - Fax:630-268-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042.005643208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty