MEDICARE: ARMENAK ASATRYAN 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	207R00000X	Internal Medicine Physician	036124064	IL

General Provider Information

NPI Number	:	1811040306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMENAK ASATRYAN M.D.

Provider Business Mailing Address
First Line	:	448 MARGATE TER
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-3359
Country	:	US
Telephone Number	:	847-236-0323
Fax Number	:

Provider Business Practice Location Address
First Line	:	1366 S MILWAUKEE AVE
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-3795
Country	:	US
Telephone Number	:	847-236-0323
Fax Number	:

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	04/15/2024

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