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1407849078

NPI Code Detail

MEDICARE: DAVID J FLORES MD

MEDICARE: DAVID J FLORES MD

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	207Q00000X	Family Medicine Physician	01060028A	IN
2	207Q00000X	Family Medicine Physician	036113814	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
2	0090000854	OTHER	IL	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1407849078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J FLORES MD

Provider Business Mailing Address
First Line	:	213 N RACINE AVE
Second Line	:	STE 100
City	:	CHICAGO
State	:	IL
Zip	:	60607-1644
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	3348 W 87TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-3767
Country	:	US
Telephone Number	:	773-776-4471
Fax Number	:	773-564-3510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	12/13/2016

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Directions to “ DAVID J FLORES MD” Practice Location

Language	Start Address	Practice Location

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