Provider Demographics
NPI:1932133451
Name:TIJUNELIS, ARAS D (MD,)
Entity Type:Individual
Prefix:MR
First Name:ARAS
Middle Name:D
Last Name:TIJUNELIS
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 1:1880 W WINCHESTER RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5341
Mailing Address - Country:US
Mailing Address - Phone:847-968-2401
Mailing Address - Fax:847-968-2402
Practice Address - Street 1:1880 W WINCHESTER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5341
Practice Address - Country:US
Practice Address - Phone:847-968-2401
Practice Address - Fax:847-968-2402
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILH26809208200000X
IL04926463208200000X
IL599090208200000X
IL036-102115208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH26809Medicare UPIN
IL599090Medicare ID - Type Unspecified