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1419 W Lake St Suite D Melrose Park IL 60160-3930 | |
| (708) 345-8255 | |
| (708) 345-0534 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1419 W Lake St, Melrose Park, Illinois |
| Authorized Official Name and Position | Beatriz Huertas-rivera (OWNER) |
| Authorized Official Contact | 7083458255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1419 W Lake St Suite D Melrose Park IL 60160-3930 Ph: (708) 345-8255 | 1419 W Lake St Suite D Melrose Park IL 60160-3930 Ph: (708) 345-8255 |
| NPI Number | 1487768941 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 03/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487768941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036113545 (Illinois) | Primary |
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