Provider Demographics
NPI:1457556433
Name:BANERJI, AROOP (ND LAC)
Entity Type:Individual
Prefix:DR
First Name:AROOP
Middle Name:
Last Name:BANERJI
Suffix:
Gender:M
Credentials:ND LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BUTTERNUT CT
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-4945
Mailing Address - Country:US
Mailing Address - Phone:847-275-2630
Mailing Address - Fax:
Practice Address - Street 1:3520 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSBURG
Practice Address - State:IL
Practice Address - Zip Code:60051-2506
Practice Address - Country:US
Practice Address - Phone:847-275-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007104133N00000X
VT0990000226175F00000X
IL198000559171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No175F00000XOther Service ProvidersNaturopath