Provider Demographics
NPI:1639107428
Name:ARTHOFER, MICHAEL G (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:ARTHOFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:587 CLARISSA CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540
Mailing Address - Country:US
Mailing Address - Phone:630-961-0632
Mailing Address - Fax:
Practice Address - Street 1:333 N MADISON ST
Practice Address - Street 2:JOLIET RADIOLOGICAL SERVICE CORP PROVENA ST JOSEPH MED
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435
Practice Address - Country:US
Practice Address - Phone:815-741-7213
Practice Address - Fax:815-741-7591
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6124854000OtherDEPARTMENT OF LABOR
9915352OtherBLUE SHIELD
ILN277224OtherHARMONY
ILN277224OtherHARMONY
C37554Medicare UPIN