Healthcare Provider Details

I. General information

NPI: 1124053673
Provider Name (Legal Business Name): ANDREW JAMES ARONSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE DEPARTMENT OF PEDIATRICS SUITE 3612
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

5000 S CORNELL AVE SUITE 14A
CHICAGO IL
60615-3041
US

V. Phone/Fax

Practice location:
  • Phone: 773-296-5625
  • Fax: 413-740-7966
Mailing address:
  • Phone: 773-241-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: