MEDICARE: DR. BEATRIZ HUERTAS RIVERA 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	036113545	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	01636473	OTHER	IL	BCBS ILLINOIS

General Provider Information

NPI Number	:	1508841982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEATRIZ HUERTAS RIVERA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 746715
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6715
Country	:	US
Telephone Number	:	773-352-1515
Fax Number	:	312-929-0373

Provider Business Practice Location Address
First Line	:	1819 N HARLEM AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-3716
Country	:	US
Telephone Number	:	773-589-4385
Fax Number	:	872-228-8601

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	06/09/2025

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