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NPI Code Detail

MEDICARE: CAVERO MEDICAL GROUP LTD

MEDICARE: CAVERO MEDICAL GROUP LTD
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 Physician042616861IL

General Provider Information

NPI Number : 1639184419
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAVERO MEDICAL GROUP LTD
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : HINSDALE
State : IL
Zip : 60522-0307
Country : US
Telephone Number : 773-767-2266
Fax Number : 773-767-3840
Provider Business Practice Location Address
First Line : 4007 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4605
Country : US
Telephone Number : 773-767-2266
Fax Number : 773-767-3933
Authorized Official
Title or Position : MANAGER
Name : MRS. VICTORIA SALINAS
Credential :
Telephone Number : 773-767-2266
Provider Enumeration Date : 07/30/2006
Last Update Date : 02/08/2018

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Directions to “CAVERO MEDICAL GROUP LTD ” Practice Location

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