Provider Demographics
NPI:1568683480
Name:AER MEDICAL
Entity Type:Organization
Organization Name:AER MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:RUMILLA,
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:773-342-8887
Mailing Address - Street 1:2810 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2915
Mailing Address - Country:US
Mailing Address - Phone:773-342-8887
Mailing Address - Fax:773-342-6257
Practice Address - Street 1:2810 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2915
Practice Address - Country:US
Practice Address - Phone:773-342-8887
Practice Address - Fax:773-342-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty