MEDICARE: MARIA OLGA CARDENAS MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	54217	WI
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036118661	IL

General Provider Information

NPI Number	:	1154408375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA OLGA CARDENAS MD

Provider Business Mailing Address
First Line	:	5140 N CALIFORNIA AVE STE 545
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3660
Country	:	US
Telephone Number	:	773-769-9200
Fax Number	:	773-506-6083

Provider Business Practice Location Address
First Line	:	5140 N CALIFORNIA AVE STE 545
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3660
Country	:	US
Telephone Number	:	773-769-9200
Fax Number	:	773-506-6083

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/10/2022

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