MEDICARE: DR. SERAFIN FRANCISCO VERAMENDI 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	207R00000X	Internal Medicine Physician	036-058501	IL

General Provider Information

NPI Number	:	1386738961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERAFIN FRANCISCO VERAMENDI M.D.

Provider Business Mailing Address
First Line	:	2243 FORESTVIEW RD.
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201
Country	:	US
Telephone Number	:	773-234-6394
Fax Number	:

Provider Business Practice Location Address
First Line	:	5318 W DEVON AVE
Second Line	:	SUITE 8
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-234-6394
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	11/21/2013

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