Individual
MS. ARIANA KARTIKA ANUGERAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 695-6868
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125069860
IL
207L00000X
Anesthesiology Physician
1700232543
IL
207L00000X
Anesthesiology Physician
Primary
S4436
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2016
Last updated
07/14/2020
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