Healthcare Provider Details

I. General information

NPI: 1417230640
Provider Name (Legal Business Name): OSCAR LINARES, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 CERMAK RD
BERWYN IL
60402-2313
US

IV. Provider business mailing address

6545 CERMAK RD
BERWYN IL
60402-2313
US

V. Phone/Fax

Practice location:
  • Phone: 708-788-0077
  • Fax: 708-788-5620
Mailing address:
  • Phone: 708-788-0077
  • Fax: 708-788-5620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0600009078
License Number StateIL

VIII. Authorized Official

Name: DR. OSCAR ROBERTO LINARES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 708-502-0414