Basic Information
Provider Information
NPI: 1487648028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOLNIK
FirstName: AARON
MiddleName: P
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4602 DEPT
Address2:  
City: CAROL STREAM
State: IL
PostalCode: 601220021
CountryCode: US
TelephoneNumber: 9062253922
FaxNumber: 9062254527
Practice Location
Address1: 1414 W FAIR AVE
Address2: SUITE 332
City: MARQUETTE
State: MI
PostalCode: 498552675
CountryCode: US
TelephoneNumber: 9062253922
FaxNumber: 9062254527
Other Information
ProviderEnumerationDate: 09/09/2005
LastUpdateDate: 04/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0000X4301030366MIY Allopathic & Osteopathic PhysiciansInternal MedicineHematology

ID Information
IDTypeStateIssuerDescription
033053401MIBLUE CROSS BLUE SHIELDOTHER
314557605MI MEDICAID
P0022813001MIRAILROAD MEDICAREOTHER


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