MEDICARE: ARJUN POUDEL

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	374700000X	Technician	12229323	IL

General Provider Information

NPI Number	:	1790442747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARJUN POUDEL

Provider Business Mailing Address
First Line	:	9425 MARGAIL AVE
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-3810
Country	:	US
Telephone Number	:	475-209-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 E TOUHY AVE
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-3303
Country	:	US
Telephone Number	:	475-209-1700
Fax Number	:

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

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	11/24/2021

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Directions to “ ARJUN POUDEL ” Practice Location

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