Provider Demographics
NPI:1841252087
Name:BAJAJ, ARUN R (MD)
Entity type:Individual
Prefix:DR
First Name:ARUN
Middle Name:R
Last Name:BAJAJ
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 1:5 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61943-7153
Mailing Address - Country:US
Mailing Address - Phone:217-346-2353
Mailing Address - Fax:217-346-2355
Practice Address - Street 1:727 E COURT ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-2460
Practice Address - Country:US
Practice Address - Phone:217-465-8411
Practice Address - Fax:217-463-3184
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036051345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
003987OtherHEALTH ALLIANCE
01500109OtherBCBS
080000789OtherMEDICARE RAILROAD
IL036051345Medicaid
ILF400336244Medicare PIN
D70191Medicare UPIN