Provider Demographics
NPI:1487310025
Name:APARTE, ARMANDO ARNOLD DATOR
Entity type:Individual
Prefix:
First Name:ARMANDO ARNOLD
Middle Name:DATOR
Last Name:APARTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 N MILWAUKEE AVE APT 6C
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1363
Mailing Address - Country:US
Mailing Address - Phone:847-975-4607
Mailing Address - Fax:
Practice Address - Street 1:1505 N MILWAUKEE AVE APT 6C
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1363
Practice Address - Country:US
Practice Address - Phone:847-975-4607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000621363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical