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NPI Code Detail

MEDICARE: REMEDIOS M SALES MD

MEDICARE: REMEDIOS M SALES 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
1207Q00000XFamily Medicine Physician036045713IL

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 : 1639106396
Entity Type Code : Individual
Provider Name (Legal Business Name) : REMEDIOS M SALES MD
Provider Business Mailing Address
First Line : 11101 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-4206
Country : US
Telephone Number : 773-821-7515
Fax Number : 773-821-6970
Provider Business Practice Location Address
First Line : 11101 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-4206
Country : US
Telephone Number : 773-821-7515
Fax Number : 773-821-6970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/02/2010

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Directions to “ REMEDIOS M SALES MD” Practice Location

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