| Salud Latinx Llc | |
|
1952 W Cermak Rd Chicago IL 60608-4204 | |
| (773) 254-6611 | |
| (773) 254-8590 |
| Full Name | Salud Latinx Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1952 W Cermak Rd, Chicago, Illinois |
| Authorized Official Name and Position | Ray A Mendez (CEO) |
| Authorized Official Contact | 3129983940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salud Latinx Llc 2014 W 22nd Pl Chicago IL 60608-4114 Ph: (312) 998-3940 | Salud Latinx Llc 1952 W Cermak Rd Chicago IL 60608-4204 Ph: (773) 254-6611 |
| NPI Number | 1598245276 |
|---|---|
| Provider Enumeration Date | 08/21/2018 |
| Last Update Date | 12/03/2018 |
| Medicare PECOS PAC ID | 1557788866 |
|---|---|
| Medicare Enrollment ID | O20200901003237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598245276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ray Andrew Mendez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043697816 PECOS PAC ID: 6406139096 Enrollment ID: I20181116001102 |
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