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NPI Code Detail

MEDICARE: DR. RODRIGO SANDOVAL MD

MEDICARE: DR. RODRIGO SANDOVAL 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
1207P00000XEmergency Medicine Physician036.175707IL

General Provider Information

NPI Number : 1588302681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RODRIGO SANDOVAL MD
Provider Business Mailing Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-6000
Fax Number :
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2022
Last Update Date : 12/10/2025

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