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NPI Code Detail

MEDICARE: MR. LUIS R FLORES I RN,CDE

MEDICARE: MR. LUIS R FLORES I RN,CDE
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
1163WD0400XDiabetes Educator Registered Nurse041290690IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2041290690OTHERNOT A MEDICARE PROVIDER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1041290690OTHERILRN,CDE
3041290690OTHERILRN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063923316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIS R FLORES I RN,CDE
Provider Business Mailing Address
First Line : 272 ADDISON RD
Second Line :
City : RIVERSIDE
State : IL
Zip : 60546-2039
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2233 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-8151
Country : US
Telephone Number : 312-770-2235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2017
Last Update Date : 05/11/2026

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