Provider Demographics
NPI:1083741110
Name:ARZE, RICARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:ARZE
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 1:6949 RIVERSIDE DR
Mailing Address - Street 2:6925 CERMAK ROAD
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2235
Mailing Address - Country:US
Mailing Address - Phone:708-484-9903
Mailing Address - Fax:708-484-9967
Practice Address - Street 1:6949 RIVERSIDE DR
Practice Address - Street 2:6925 CERMAK ROAD
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2235
Practice Address - Country:US
Practice Address - Phone:708-484-9903
Practice Address - Fax:708-484-9967
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36078569Medicaid
IL36078569Medicaid