Provider Demographics
NPI:1487644217
Name:DWORIN, AARON MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:DWORIN
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 1:1160 PARK AVE W
Mailing Address - Street 2:SUITE 1 NORTH
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2230
Mailing Address - Country:US
Mailing Address - Phone:847-433-2620
Mailing Address - Fax:847-433-8727
Practice Address - Street 1:1160 PARK AVE W
Practice Address - Street 2:SUITE 1 NORTH
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2230
Practice Address - Country:US
Practice Address - Phone:847-433-2620
Practice Address - Fax:847-433-8727
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCAD8923446OtherUS DEPT OF JUSTICE
ILL010524Medicaid
ILL010524Medicaid
619070Medicare ID - Type Unspecified