Eden Aurelio MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDEN AURELIO MD SC

Practice address

301 17TH Ave
East Moline, IL 61244-2028

Phone

(309) 755-4548

Fax

(309) 755-4774

NPI assigned

Feb 12, 2008

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eden Gonzales Aurelio, MD

Title

MD Physician

Phone

(309) 755-4548

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1952579054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 17TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442028",
            "telephone_number": "309-755-4548",
            "fax_number": "309-755-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 17TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442028",
            "telephone_number": "309-755-4548",
            "fax_number": "309-755-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN AURELIO MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "AURELIO",
        "authorized_official_first_name": "EDEN",
        "authorized_official_middle_name": "GONZALES",
        "authorized_official_title_or_position": "MD PHYSICIAN",
        "authorized_official_telephone_number": "309-755-4548",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36066418",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "08105516",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in East Moline, IL
• Providers in East Moline, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.