MEDICARE: RUSALINA C. MUNTEAN-MINCU 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	207R00000X	Internal Medicine Physician	036097673	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1295782431	OTHER	IL	NPI I

General Provider Information

NPI Number	:	1295782431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSALINA C. MUNTEAN-MINCU MD

Provider Business Mailing Address
First Line	:	PO BOX 746721
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6721
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	4848 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2718
Country	:	US
Telephone Number	:	773-724-6200
Fax Number	:	773-866-8015

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	08/25/2021

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