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NPI Code Detail

MEDICARE: DR. GENARO ROMO JR.

MEDICARE:  DR. GENARO  ROMO JR.
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
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1811978471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GENARO ROMO JR.
Provider Business Mailing Address
First Line : 4146 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60632-1825
Country : US
Telephone Number : 773-247-3345
Fax Number : 773-927-3862
Provider Business Practice Location Address
First Line : 4146 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60632-1825
Country : US
Telephone Number : 773-247-3345
Fax Number : 773-927-3862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 07/08/2007

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Directions to “ DR. GENARO ROMO JR. ” Practice Location

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