Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036132707 | IL |
N | 111NI0900X | Internist | 036132707 | IL |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036132707 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036132707 | IL |
NPI | 1245556547 |
---|---|
Provider Name | Dr. Ashish Haryani |
First Address | Woodridge, IL 60517-4907 |
Second Address | Elk Grove Village, IL 60007-3372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 16/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036132707 | (05) | IL |
1720371669 | GROUP PRACTICE NPI (01) | IL |
DS2377 | RRMC GROUP PTAN (01) | IL |
F400412765 | MEDICARE PTAN LOC 16 (01) | IL |
F400412766 | MEDICARE PTAN LOC 15 (01) | IL |