MEDICARE: RAY ANDREW MENDEZ 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	036.145335	IL
2	207Q00000X	Family Medicine Physician	125066793	IL

General Provider Information

NPI Number	:	1043697816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAY ANDREW MENDEZ M.D.

Provider Business Mailing Address
First Line	:	1952 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-4204
Country	:	US
Telephone Number	:	773-254-6611
Fax Number	:	773-254-9590

Provider Business Practice Location Address
First Line	:	1952 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-4204
Country	:	US
Telephone Number	:	773-254-6611
Fax Number	:	773-254-8590

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

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	01/06/2026

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