Healthcare Provider Details

I. General information

NPI: 1285726570
Provider Name (Legal Business Name): PREVENTIVE MEDICAL ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 MACOM DR STE 103
NAPERVILLE IL
60564-9355
US

IV. Provider business mailing address

1308 MACOM DR STE 103
NAPERVILLE IL
60564-9355
US

V. Phone/Fax

Practice location:
  • Phone: 630-585-0800
  • Fax: 630-585-6331
Mailing address:
  • Phone: 630-585-0800
  • Fax: 630-585-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-082908
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036-082908
License Number StateIL

VIII. Authorized Official

Name: DR. HARDEEP ARORA
Title or Position: PRESIDENT
Credential: MD
Phone: 630-585-0800