Healthcare Provider Details

I. General information

NPI: 1295768588
Provider Name (Legal Business Name): HECTOR LUIS FLORES-ARROYO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 W CHICAGO AVE SUITE 2
CHICAGO IL
60622-5512
US

IV. Provider business mailing address

1802 W CHICAGO AVE SUITE 2
CHICAGO IL
60622-5512
US

V. Phone/Fax

Practice location:
  • Phone: 773-278-2998
  • Fax: 773-278-2997
Mailing address:
  • Phone: 773-278-2998
  • Fax: 773-278-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number036-090820
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036-090820
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-090820
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: