MEDICARE: DR. ARCADIO HILARIO VALENZUELA POMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036-112813	IL

General Provider Information

NPI Number	:	1003810953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARCADIO HILARIO VALENZUELA POMER M.D.

Provider Business Mailing Address
First Line	:	1400 E GOLF RD
Second Line	:	SUITE 118
City	:	DES PLAINES
State	:	IL
Zip	:	60016-1236
Country	:	US
Telephone Number	:	847-635-2001
Fax Number	:	847-635-2076

Provider Business Practice Location Address
First Line	:	1400 E GOLF RD
Second Line	:	SUITE 118
City	:	DES PLAINES
State	:	IL
Zip	:	60016-1236
Country	:	US
Telephone Number	:	847-635-2001
Fax Number	:	847-635-2076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/20/2022

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