Healthcare Provider Details

I. General information

NPI: 1215937909
Provider Name (Legal Business Name): B. Q. FIGUERRES, MDSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 1ST ST
SPRING VALLEY IL
61362-1512
US

IV. Provider business mailing address

600 E 1ST ST
SPRING VALLEY IL
61362-1512
US

V. Phone/Fax

Practice location:
  • Phone: 815-664-4997
  • Fax: 815-664-2012
Mailing address:
  • Phone: 815-664-4997
  • Fax: 815-664-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: BENEDICTO QUEDADO FIGUERRES
Title or Position: PRESIDENT
Credential: MD
Phone: 815-664-4997