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General NPI Number Information
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NPI Number | 1447251160
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Entity Type | Individual
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Provider Name | ANTRANIK S POLADIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 900 JORIE BLVD
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City | OAK BROOK
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State | IL
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Zip | 60523
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Country | US
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Telephone | 630-954-6700
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Fax | 963-954-1555
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Provider Business Mailing Address
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Address Line | 900 JORIE BLVD
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City | OAK BROOK
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State | IL
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Zip | 60523
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Country | US
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Telephone | 630-954-6700
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Fax | 963-954-1555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-079591
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036-079591
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License Number State | IL
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