Provider Demographics
NPI:1770913931
Name:ARJUNAN, AISHWARYA (MS, MPH)
Entity type:Individual
Prefix:MS
First Name:AISHWARYA
Middle Name:
Last Name:ARJUNAN
Suffix:
Gender:F
Credentials:MS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E. CHICAGO AVENUE
Mailing Address - Street 2:BOX #59
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2605
Mailing Address - Country:US
Mailing Address - Phone:312-227-6761
Mailing Address - Fax:312-227-9413
Practice Address - Street 1:225 E. CHICAGO AVENUE
Practice Address - Street 2:BOX #59
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2605
Practice Address - Country:US
Practice Address - Phone:312-227-6761
Practice Address - Fax:312-227-9413
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL247.000052170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS