Provider Demographics
NPI:1871773424
Name:ARACELI I. FERIA, M.D.S.C.
Entity type:Organization
Organization Name:ARACELI I. FERIA, M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:ILAGAN
Authorized Official - Last Name:FERIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-636-6531
Mailing Address - Street 1:10448 S PULASKI RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4895
Mailing Address - Country:US
Mailing Address - Phone:708-636-6531
Mailing Address - Fax:708-636-6549
Practice Address - Street 1:10448 S PULASKI RD
Practice Address - Street 2:SUITE 10
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4895
Practice Address - Country:US
Practice Address - Phone:708-636-6531
Practice Address - Fax:708-636-6549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063512986OtherNPI
ILC07F03OtherAETNA HEALTH PLAN
IL036054271Medicaid
IL080084981OtherPALMETTO, GBA
IL21606679OtherBLUE CROSS BLUE SHIELD
IL4064717OtherAETNA MANAGED CARE
IL490380Medicare PIN
IL4064717OtherAETNA MANAGED CARE