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NPI Code Detail

MEDICARE: DR. PONNI ARUNKUMAR MD

MEDICARE: DR. PONNI ARUNKUMAR 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
1207ZF0201XForensic Pathology Physician036106166IL

General Provider Information

NPI Number : 1588124960
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PONNI ARUNKUMAR MD
Provider Business Mailing Address
First Line : 2121 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3705
Country : US
Telephone Number : 312-666-0500
Fax Number : 312-997-3024
Provider Business Practice Location Address
First Line : 2121 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3705
Country : US
Telephone Number : 312-666-0500
Fax Number : 312-997-3024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2019
Last Update Date : 03/22/2019

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