Provider Demographics
NPI:1265503494
Name:ARRIOLA, ERMIN AMROS (MD)
Entity type:Individual
Prefix:
First Name:ERMIN
Middle Name:AMROS
Last Name:ARRIOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:332 S MICHIGAN AVE
Mailing Address - Street 2:STE 1032A997
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4434
Mailing Address - Country:US
Mailing Address - Phone:773-209-6551
Mailing Address - Fax:888-871-7187
Practice Address - Street 1:6001 CRAIN ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2941
Practice Address - Country:US
Practice Address - Phone:773-209-6551
Practice Address - Fax:888-871-7187
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-092712208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1265503494OtherNPI
ILL91698Medicare PIN
ILG47284Medicare UPIN