Healthcare Provider Details

I. General information

NPI: 1205824836
Provider Name (Legal Business Name): ANATOLY LAZAREVICH ARBER MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N RIVERSIDE DR STE 213
GURNEE IL
60031-5918
US

IV. Provider business mailing address

501 N RIVERSIDE DR STE 213
GURNEE IL
60031-5918
US

V. Phone/Fax

Practice location:
  • Phone: 847-625-9500
  • Fax: 847-625-9565
Mailing address:
  • Phone: 847-625-9500
  • Fax: 847-625-9565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number36-088261
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: