MEDICARE: MUKESH ARORA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0036 097 343	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	05623054	OTHER	IL	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1518975796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUKESH ARORA MD

Provider Business Mailing Address
First Line	:	690 E TERRA COTTA AVE
Second Line	:	SUITE D
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-3605
Country	:	US
Telephone Number	:	815-455-8600
Fax Number	:	815-455-8601

Provider Business Practice Location Address
First Line	:	690 E TERRA COTTA AVE
Second Line	:	SUITE D
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-3605
Country	:	US
Telephone Number	:	815-455-8600
Fax Number	:	815-455-8601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	10/03/2011

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Directions to “ MUKESH ARORA MD” Practice Location

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