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General NPI Number Information
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NPI Number | 1023277019
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Entity Type | Organization
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Legal Business Name | ROGELIO O CAVE MD SC
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 67 W 111TH ST 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60628-4247
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Country | US
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Telephone | 773-995-3454
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 S KILBOURN AVE
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City | OAK LAWN
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State | IL
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Zip | 60453-3208
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Country | US
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Telephone | 708-422-3716
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Fax |
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Authorized Official
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Title or Position | BILLING CONSULTANT
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Name | ROSITA DOYLE
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Credential |
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Telephone | 773-846-9521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036050538
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License Number State | IL
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