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General NPI Number Information
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NPI Number | 1033241880
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Entity Type | Organization
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Legal Business Name | THE CHEST CENTER
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2508 25TH ST STE B BLACKHAWK MEDICAL BLDG.
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5419
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Country | US
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Telephone | 309-788-5864
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Fax | 309-788-5868
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Provider Business Mailing Address
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Address Line | 2508 25TH ST STE B BLACKHAWK MEDICAL BLDG.
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5419
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Country | US
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Telephone | 309-788-5864
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Fax | 309-788-5868
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Authorized Official
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Title or Position | OWNER
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Name | DR. FELIPE P. ENRIQUEZ
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Credential | M.D.
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Telephone | 309-788-5864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | IL
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