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General NPI Number Information
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NPI Number | 1982849576
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Entity Type | Organization
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Legal Business Name | J P ARTEAGA CORPORATION
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 1845 W 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60609-3844
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Country | US
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Telephone | 773-927-5524
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 S STATE ST UNIT 918
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City | CHICAGO
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State | IL
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Zip | 60605-1928
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Country | US
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Telephone | 773-927-5524
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | JACQUELINE P ARTEAGA
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Credential | MD
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Telephone | 773-927-5524
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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 | 036119408
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License Number State | IL
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