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General NPI Number Information
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NPI Number | 1467031716
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Entity Type | Individual
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Provider Name | ARJUN KAVERIMANIAN
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Gender | Male
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 206 N RANDOLPH ST. SECOND FLOOR, PRIVATE OFFICE 246
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City | CHAMPAIGN
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State | IL
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Zip | 61820
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Country | US
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Telephone | 833-351-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 888-584-7888
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 338945-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.171026
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License Number State | IL
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