Provider Demographics
NPI:1881623528
Name:KRIKORIAN, ARMAND A (MD)
Entity type:Individual
Prefix:
First Name:ARMAND
Middle Name:A
Last Name:KRIKORIAN
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 1:4440 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087491207RE0101X
IL036131731207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2638846Medicaid
OH363725OtherWELLCARE
OH000000224437OtherUNISON
OH000000539577OtherANTHEM
OH745086OtherBUCKEYE
OH7398784OtherAETNA
OHP00337970OtherRAILROAD MEDICARE
OHP00605161Medicare PIN
I55142Medicare UPIN
OH000000224437OtherUNISON
OH7398784OtherAETNA