MEDICARE: DR. MIGUEL CAMARA 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	207KA0200X	Allergy Physician	036092279	IL

General Provider Information

NPI Number	:	1447369327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL CAMARA M.D.

Provider Business Mailing Address
First Line	:	2228 WEBER RD
Second Line	:
City	:	CREST HILL
State	:	IL
Zip	:	60403-0928
Country	:	US
Telephone Number	:	815-729-9900
Fax Number	:	815-729-9913

Provider Business Practice Location Address
First Line	:	2228 WEBER RD
Second Line	:
City	:	CREST HILL
State	:	IL
Zip	:	60403-0928
Country	:	US
Telephone Number	:	815-729-9900
Fax Number	:	815-729-9913

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/26/2017

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