Provider Demographics
NPI:1093871246
Name:ARUN, VEENA V (MD)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:V
Last Name:ARUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 E 53RD ST STE 1002
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4572
Mailing Address - Country:US
Mailing Address - Phone:773-288-2020
Mailing Address - Fax:
Practice Address - Street 1:1525 E 53RD ST STE 1002
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4572
Practice Address - Country:US
Practice Address - Phone:773-288-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100274207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100274Medicaid