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NPI Code Detail

MEDICARE: DR. JOSE FRANCISCO ELIZONDO MD

MEDICARE: DR. JOSE FRANCISCO ELIZONDO 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
1207Q00000XFamily Medicine Physician036085068IL

General Provider Information

NPI Number : 1912934985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE FRANCISCO ELIZONDO MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 N RAVENSWOOD AVE
Second Line : 2ND FLOOR
City : CHICAGO
State : IL
Zip : 60640-4510
Country : US
Telephone Number : 773-561-7500
Fax Number : 773-561-7612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 02/13/2025

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