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General NPI Number Information
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NPI Number | 1013254341
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Entity Type | Organization
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Legal Business Name | HECTOR L. SALCEDO M.D. S.C.
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 3132 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647-8415
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Country | US
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Telephone | 773-227-3132
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Fax | 773-227-3309
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Provider Business Mailing Address
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Address Line | 4455 MADISON ST
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City | SKOKIE
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State | IL
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Zip | 60076-2628
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Country | US
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Telephone | 773-227-3132
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Fax | 773-227-3309
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Authorized Official
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Title or Position | FAMILY PRACTITIONER
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Name | DR. HECTOR L SALCEDO
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Credential | M.D.
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Telephone | 773-227-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036128912
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License Number State | IL
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