Healthcare Provider Details

I. General information

NPI: 1306848171
Provider Name (Legal Business Name): ADA I. ARIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W DIVISION ST STE 335
CHICAGO IL
60622-2995
US

IV. Provider business mailing address

1S376 SUMMIT AVE STE 4C
OAKBROOK TERRACE IL
60181-3966
US

V. Phone/Fax

Practice location:
  • Phone: 773-342-5781
  • Fax:
Mailing address:
  • Phone: 630-424-1122
  • Fax: 630-324-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0360644792
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036064792
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: