Provider Demographics
NPI:1013171636
Name:BALARAM, AJAY K (MD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:K
Last Name:BALARAM
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 1:515 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4439
Mailing Address - Country:US
Mailing Address - Phone:847-956-0099
Mailing Address - Fax:847-956-0099
Practice Address - Street 1:515 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4439
Practice Address - Country:US
Practice Address - Phone:847-956-0099
Practice Address - Fax:847-956-0099
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125051809207X00000X
NY261302390200000X
IL036.123743207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program