Provider Demographics
NPI:1043317357
Name:AMIN, NARAYAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:NARAYAN
Middle Name:R
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-9006
Mailing Address - Country:US
Mailing Address - Phone:217-554-4079
Mailing Address - Fax:
Practice Address - Street 1:VAIHCS - 112/DR N AMIN
Practice Address - Street 2:1900 E. MAIN ST.
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832
Practice Address - Country:US
Practice Address - Phone:217-554-4079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology