MEDICARE: VEIN CARE SPECIALISTS. LTD

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	202K00000X	Phlebology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4932251	OTHER	IL	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1134207145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEIN CARE SPECIALISTS. LTD

Provider Business Mailing Address
First Line	:	712 N DEARBORN ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3846
Country	:	US
Telephone Number	:	312-867-0020
Fax Number	:	312-448-6117

Provider Business Practice Location Address
First Line	:	712 N DEARBORN ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3846
Country	:	US
Telephone Number	:	312-867-0020
Fax Number	:	312-448-6117

Authorized Official
Title or Position	:	OWNER & CEO
Name	:	DR. SALVADOR YUNEZ
Credential	:	MD
Telephone Number	:	312-867-0020

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	05/15/2024

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