MEDICARE: ELADIO A VARGAS MD S C

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
1	207R00000X	Internal Medicine Physician	036051813	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225150055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELADIO A VARGAS MD S C

Provider Business Mailing Address
First Line	:	1500 WAUKEGAN ROAD
Second Line	:	#221
City	:	GLENVIEW
State	:	IL
Zip	:	60025-2165
Country	:	US
Telephone Number	:	847-998-0120
Fax Number	:	847-998-0131

Provider Business Practice Location Address
First Line	:	1500 WAUKEGAN ROAD
Second Line	:	#221
City	:	GLENVIEW
State	:	IL
Zip	:	60025-2165
Country	:	US
Telephone Number	:	847-998-0120
Fax Number	:	847-998-0131

Authorized Official
Title or Position	:	MD
Name	:	ELADIO A VARGAS
Credential	:	MD
Telephone Number	:	847-998-0120

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	06/17/2010

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