Provider Demographics
NPI:1588861728
Name:MUSABJI, ARIS M (MD)
Entity type:Individual
Prefix:
First Name:ARIS
Middle Name:M
Last Name:MUSABJI
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 1:270 W LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2034
Mailing Address - Country:US
Mailing Address - Phone:630-653-8464
Mailing Address - Fax:630-653-8660
Practice Address - Street 1:270 W LOOP RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2034
Practice Address - Country:US
Practice Address - Phone:630-653-8464
Practice Address - Fax:630-653-8660
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0896732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2790065Medicaid
ILR01658Medicare UPIN
OHMU4216591Medicare PIN