Healthcare Provider Details

I. General information

NPI: 1689758914
Provider Name (Legal Business Name): SHEILAH BRIDGET CINTRON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W NORTH AVE SUITE 203
MELROSE PARK IL
60160-1634
US

IV. Provider business mailing address

675 W NORTH AVE SUITE 203
MELROSE PARK IL
60160-1634
US

V. Phone/Fax

Practice location:
  • Phone: 708-681-7690
  • Fax: 708-681-7655
Mailing address:
  • Phone: 708-681-7690
  • Fax: 708-681-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-081323
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: