1376775205 NPI number — DR. MELCHOR PAULO A ARANAS M.D.

Table of content: MR. TREVOR JAMES JEWETT MA (NPI 1225613714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376775205 NPI number — DR. MELCHOR PAULO A ARANAS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARANAS
Provider First Name:
MELCHOR PAULO
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376775205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
725 SCHOOL ST STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRIS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60450-1207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-941-9124
Provider Business Mailing Address Fax Number:
815-941-4363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1306 GEMINI CIR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OTTAWA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61350-1695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-433-9200
Provider Business Practice Location Address Fax Number:
815-705-1716
Provider Enumeration Date:
08/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036130527 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com