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General NPI Number Information
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NPI Number | 1962690495
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Entity Type | Organization
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Legal Business Name | EDGAR J VARGAS, MD LTD
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 2233 W DIVISION ST
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City | CHICAGO
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State | IL
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Zip | 60622-8151
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Country | US
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Telephone | 773-934-4242
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 861
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City | MT PROSPECT
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State | IL
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Zip | 60056-0861
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Country | US
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Telephone | 312-263-1102
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDGAR J VARGAS
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Credential | MD
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Telephone | 773-934-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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