Healthcare Provider Details

I. General information

NPI: 1346421591
Provider Name (Legal Business Name): ERIKA J FLORES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 N HALSTED ST STE 202
CHICAGO IL
60642-2612
US

IV. Provider business mailing address

1460 N HALSTED ST STE 202
CHICAGO IL
60642-2612
US

V. Phone/Fax

Practice location:
  • Phone: 773-871-4409
  • Fax: 773-871-3608
Mailing address:
  • Phone: 773-871-4409
  • Fax: 773-871-3608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number125052347
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125052347
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: