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NPI Code Detail

MEDICARE: VALENTINALB,S.C.

MEDICARE: VALENTINALB,S.C.
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 Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548541022
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALENTINALB,S.C.
Provider Business Mailing Address
First Line : 4727 N CLARK ST STE 1N
Second Line :
City : CHICAGO
State : IL
Zip : 60640-7554
Country : US
Telephone Number : 773-334-9300
Fax Number :
Provider Business Practice Location Address
First Line : 4727 N CLARK ST STE 1N
Second Line :
City : CHICAGO
State : IL
Zip : 60640-7554
Country : US
Telephone Number : 773-334-9300
Fax Number : 177-333-4930
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : ANNA MORGAN
Credential : M.D.
Telephone Number : 773-334-9300
Provider Enumeration Date : 08/29/2011
Last Update Date : 10/22/2024

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Directions to “VALENTINALB,S.C. ” Practice Location

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