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1710211503

NPI Code Detail

MEDICARE: DANIEL BORJA CACHO MD

MEDICARE: DANIEL BORJA CACHO 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
1	204F00000X	Transplant Surgery Physician	3306900	ZZ
2	204F00000X	Transplant Surgery Physician	036.145724	IL

General Provider Information

NPI Number	:	1710211503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL BORJA CACHO MD

Provider Business Mailing Address
First Line	:	676 N SAINT CLAIR ST STE 1900
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2986
Country	:	US
Telephone Number	:	312-695-8900
Fax Number	:	312-695-9194

Provider Business Practice Location Address
First Line	:	676 N SAINT CLAIR ST STE 1900
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2986
Country	:	US
Telephone Number	:	312-695-8900
Fax Number	:	312-695-9194

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

Provider Enumeration Date	:	09/25/2009
Last Update Date	:	04/18/2018

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Directions to “ DANIEL BORJA CACHO MD” Practice Location

Language	Start Address	Practice Location

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