MEDICARE: ADA I. ARIAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	0360644792	IL
2	207RP1001X	Pulmonary Disease Physician	036064792	IL

General Provider Information

NPI Number	:	1306848171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADA I. ARIAS M.D.

Provider Business Mailing Address
First Line	:	1S376 SUMMIT AVE STE 4C
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-3966
Country	:	US
Telephone Number	:	630-424-1122
Fax Number	:	630-324-0067

Provider Business Practice Location Address
First Line	:	2222 W DIVISION ST STE 335
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2995
Country	:	US
Telephone Number	:	773-342-5781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	06/28/2021

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