MEDICARE: DR. KENNETH R ARBETTER MD

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	207R00000X	Internal Medicine Physician	036099519	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110184179	OTHER	IL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336132851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH R ARBETTER MD

Provider Business Mailing Address
First Line	:	259 E ERIE ST
Second Line	:	SUITE 2300
City	:	CHICAGO
State	:	IL
Zip	:	60611-2987
Country	:	US
Telephone Number	:	312-926-6000
Fax Number	:	312-926-5971

Provider Business Practice Location Address
First Line	:	259 E ERIE ST
Second Line	:	SUITE 2300
City	:	CHICAGO
State	:	IL
Zip	:	60611-2987
Country	:	US
Telephone Number	:	312-926-6000
Fax Number	:	312-926-5971

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	04/28/2016

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