Healthcare Provider Details

I. General information

NPI: 1730289273
Provider Name (Legal Business Name): AALOK AVINASHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E 51ST ST
CHICAGO IL
60615-2400
US

IV. Provider business mailing address

8435 KEELER AVE
SKOKIE IL
60076-2009
US

V. Phone/Fax

Practice location:
  • Phone: 312-572-2515
  • Fax: 312-572-2504
Mailing address:
  • Phone: 847-329-0411
  • Fax: 847-329-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-083475
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036-083475
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: