Provider Demographics
NPI:1861590689
Name:KUMAR, ARVIND (MD)
Entity type:Individual
Prefix:
First Name:ARVIND
Middle Name:
Last Name:KUMAR
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:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:17495 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7581
Practice Address - Country:US
Practice Address - Phone:630-364-7850
Practice Address - Fax:708-226-7172
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075336207Q00000X, 207RH0003X
IL036-075336207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205474003OtherMEDICARE INDIV ID# FOR GROUP 205474
IL208256004OtherMEDICARE INDIV ID# FOR GROUP 208256
IL0360753361Medicaid
IL09907357OtherBCBS
IL336140003OtherMEDICARE INDIV ID# FOR GROUP 336140
ILP00839590OtherMEDICARE RAILROAD
ILC31261OtherMEDICARE RAOROAD GROUP PTAN
IL208256004OtherMEDICARE INDIV ID# FOR GROUP 208256
ILP00839590OtherMEDICARE RAILROAD
E98991Medicare UPIN
ILC31261OtherMEDICARE RAOROAD GROUP PTAN
IL208256Medicare PIN