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NPI Code Detail

MEDICARE: LUIS E UGARTE MD

MEDICARE: LUIS E UGARTE 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
1207V00000XObstetrics & Gynecology Physician036047127IL

Other Identifiers

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

General Provider Information

NPI Number : 1629076781
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS E UGARTE MD
Provider Business Mailing Address
First Line : 152 W LINCOLN HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2619
Country : US
Telephone Number : 708-755-7359
Fax Number : 708-754-3071
Provider Business Practice Location Address
First Line : 152 W LINCOLN HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2619
Country : US
Telephone Number : 708-755-7359
Fax Number : 708-754-3071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 06/07/2012

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