| Rogelio Liboon Md Sc | |
|
1937 W 35th St Chicago IL 60609-1206 | |
| (773) 523-8014 | |
| (630) 654-4362 |
| Full Name | Rogelio Liboon Md Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 1937 W 35th St, Chicago, Illinois |
| Authorized Official Name and Position | Rogelio N Liboon (PRESIDENT) |
| Authorized Official Contact | 7735238014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rogelio Liboon Md Sc 1937 W 35th St Chicago IL 60609-1206 Ph: (773) 523-8014 | Rogelio Liboon Md Sc 1937 W 35th St Chicago IL 60609-1206 Ph: (773) 523-8014 |
| NPI Number | 1548441314 |
|---|---|
| Provider Enumeration Date | 11/20/2007 |
| Last Update Date | 07/15/2014 |
| Medicare PECOS PAC ID | 6901985720 |
|---|---|
| Medicare Enrollment ID | O20080506000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548441314 | NPI | - | NPPES |
| 036047971 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036047971 (Illinois) | Primary |
| Provider Name | Rogelio N Liboon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205834934 PECOS PAC ID: 9739268558 Enrollment ID: I20080506000196 |
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