Basic Information
| Provider Information | |||||||||
| NPI: | 1023017480 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADA I ARIAS MD SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1S376 SUMMIT AVE STE 4C | ||||||||
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| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304241122 | ||||||||
| FaxNumber: | 6303240067 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 W DIVISION ST STE 335 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606222995 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7733425781 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ARIAS | ||||||||
| AuthorizedOfficialFirstName: | ADA | ||||||||
| AuthorizedOfficialMiddleName: | I. | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIR | ||||||||
| AuthorizedOfficialTelephone: | 7733425781 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 11/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.