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NPI Code Detail

MEDICARE: MAXIMO BERMUDEZ MD

MEDICARE: MAXIMO BERMUDEZ 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
1207Q00000XFamily Medicine Physician036-090194IL

General Provider Information

NPI Number : 1497836142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAXIMO BERMUDEZ MD
Provider Business Mailing Address
First Line : 2424 W PETERSON AVE
Second Line : SUITE 200
City : CHICAGO
State : IL
Zip : 60659-4100
Country : US
Telephone Number : 312-526-2000
Fax Number : 312-526-2152
Provider Business Practice Location Address
First Line : 2424 W PETERSON AVE
Second Line : SUITE 200
City : CHICAGO
State : IL
Zip : 60659-4100
Country : US
Telephone Number : 773-761-0300
Fax Number : 773-761-0009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 08/22/2022

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