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General NPI Number Information
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NPI Number | 1710160130
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Entity Type | Organization
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Legal Business Name | MUNOZ M.D. AND CVENGROS M.D., S.C.
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 2800 N SHERIDAN RD SUITE G2
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City | CHICAGO
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State | IL
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Zip | 60657-6156
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Country | US
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Telephone | 773-755-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 195 N HARBOR DR 4708
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City | CHICAGO
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State | IL
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Zip | 60601-7514
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Country | US
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Telephone | 773-755-2600
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TERESA CVENGROS
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Credential |
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Telephone | 773-755-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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