Provider Demographics
NPI:1922045376
Name:ARANADOR, DERCY J (MD)
Entity Type:Individual
Prefix:DR
First Name:DERCY
Middle Name:J
Last Name:ARANADOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 N COMMONWEALTH AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6211
Mailing Address - Country:US
Mailing Address - Phone:773-665-3124
Mailing Address - Fax:773-665-3408
Practice Address - Street 1:2913 N COMMONWEALTH AVE FL 5
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6211
Practice Address - Country:US
Practice Address - Phone:773-665-3124
Practice Address - Fax:773-665-3408
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036049190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036049190Medicaid
C41934Medicare UPIN
IL036049190Medicaid