Provider Demographics
NPI:1891873048
Name:ARAIN, ATAULLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ATAULLAH
Middle Name:
Last Name:ARAIN
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 1:4121 FAIRVIEW AVE STE L1
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2265
Mailing Address - Country:US
Mailing Address - Phone:630-674-1160
Mailing Address - Fax:
Practice Address - Street 1:4121 FAIRVIEW AVE STE L1
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2265
Practice Address - Country:US
Practice Address - Phone:630-674-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02201168OtherBCBS OF IL
ILC39318Medicare UPIN
IL602230Medicare ID - Type UnspecifiedMEDICARE