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NPI Code Detail

MEDICARE: MR. JAVIER VILLARREAL

MEDICARE:  MR. JAVIER  VILLARREAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171R00000XInterpreter

General Provider Information

NPI Number : 1003146796
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAVIER VILLARREAL
Provider Business Mailing Address
First Line : 1122 PORT ROYAL RD
Second Line :
City : PINGREE GROVE
State : IL
Zip : 60140-9196
Country : US
Telephone Number : 224-639-5017
Fax Number :
Provider Business Practice Location Address
First Line : 1122 PORT ROYAL RD
Second Line :
City : PINGREE GROVE
State : IL
Zip : 60140-9196
Country : US
Telephone Number : 224-639-5017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2010
Last Update Date : 01/03/2010

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Directions to “ MR. JAVIER VILLARREAL ” Practice Location

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