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NPI Code Detail

MEDICARE: DR. LOURDES RIVERO DDS

MEDICARE: DR. LOURDES RIVERO DDS
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
11223G0001XGeneral Practice Dentistry019-021582IL

General Provider Information

NPI Number : 1922179795
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOURDES RIVERO DDS
Provider Business Mailing Address
First Line : 4066 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-1831
Country : US
Telephone Number : 773-541-8137
Fax Number :
Provider Business Practice Location Address
First Line : 4066 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-1831
Country : US
Telephone Number : 773-541-8137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 12/08/2023

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Directions to “ DR. LOURDES RIVERO DDS” Practice Location

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