Provider Demographics
NPI:1497995872
Name:ANTHONY M AURIEMMA MD SC
Entity Type:Organization
Organization Name:ANTHONY M AURIEMMA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:AURIEMMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-887-2900
Mailing Address - Street 1:460 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-6145
Mailing Address - Country:US
Mailing Address - Phone:630-887-2900
Mailing Address - Fax:630-986-2440
Practice Address - Street 1:460 QUAIL RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6145
Practice Address - Country:US
Practice Address - Phone:630-887-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042618962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036113958Medicaid