MEDICARE: DR. ANTHONY JOSEPH GARCIA 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	208D00000X	General Practice Physician	036.109200	IL

General Provider Information

NPI Number	:	1407067713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY JOSEPH GARCIA M.D.

Provider Business Mailing Address
First Line	:	826 S MILLER ST
Second Line	:	SUITE 1
City	:	CHICAGO
State	:	IL
Zip	:	60607-4207
Country	:	US
Telephone Number	:	318-773-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 S MILLER ST
Second Line	:	SUITE 1
City	:	CHICAGO
State	:	IL
Zip	:	60607-4207
Country	:	US
Telephone Number	:	318-773-2850
Fax Number	:

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	12/03/2008

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