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General NPI Number Information
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NPI Number | 1255444170
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Entity Type | Organization
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Legal Business Name | HISPANIC HEALTH FOUNDATION, INC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3456 W 79TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-1442
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Country | US
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Telephone | 773-737-1990
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Fax | 773-737-4981
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Provider Business Mailing Address
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Address Line | PO BOX 388320
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City | CHICAGO
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State | IL
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Zip | 60638-8320
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Country | US
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Telephone | 773-767-4600
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Fax | 773-767-8320
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN PAUL CUEVA
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Credential | M.D.
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Telephone | 773-767-1990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | IL
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