Healthcare Provider Details

I. General information

NPI: 1952325664
Provider Name (Legal Business Name): ROBERT JOHN PRADO SAQUETON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 DEMPSTER ST
SKOKIE IL
60076-2101
US

IV. Provider business mailing address

PO BOX 746715
ATLANTA GA
30374-6715
US

V. Phone/Fax

Practice location:
  • Phone: 224-601-7032
  • Fax:
Mailing address:
  • Phone: 773-352-1515
  • Fax: 312-929-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-090721
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: