Healthcare Provider Details

I. General information

NPI: 1396956645
Provider Name (Legal Business Name): VIKAS ARORA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N MAIN ST CHOATE MENTAL HEALTH HOSPITAL AND DEV CENTER
ANNA IL
62906-1652
US

IV. Provider business mailing address

1000 N MAIN ST CHOATE MENTAL HEALTH HOSPITAL AND DEV CENTER
ANNA IL
62906-1652
US

V. Phone/Fax

Practice location:
  • Phone: 618-833-5161
  • Fax:
Mailing address:
  • Phone: 618-833-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number044543
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.114769
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: