Renato M Arias, MD – Family Medicine Physician

Key facts

NPI: 1376571026
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 036-045081 (IL)
Practice address: 1415 W Lake St
Addison, IL 60101-1870
Phone: (847) 981-5767
Fax: (847) 981-5765
NPI assigned: Jun 30, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Bonaventure Medical Foundation, LLC Family Medicine Physician · Elk Grove Village, IL · NPI 1588775647

NPD (past) FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
036-045081	IL	MD	Family Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Bonaventure Medical Foundation, LLC	Family Medicine	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	036-045081	IL	Yes

Addresses

Primary practice location

1415 W Lake St
Addison, IL 60101-1870

Mailing address

3040 W Salt Creek LN
Arlington Heights, IL 60005-1069

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376571026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 W SALT CREEK LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011870",
            "telephone_number": "847-981-5767",
            "fax_number": "847-981-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIAS",
        "first_name": "RENATO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-045081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

All providers in Addison, IL · Family Medicine Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.