Bardales, Alfonso S
Bardales, Alfonso S is an sole proprietor health care provider with primary practice located at 3339 W 55Th St , Chicago IL 60632-3249. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Bardales, Alfonso S can be contacted via phone (773) 471-3600.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 036056659 | Illinois |
Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 036056659 | Illinois |
Profile Details
NPI number | 1124075700 |
---|---|
LBN Legal business name | Bardales, Alfonso S |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 28th, 2006 |
Last updated | Sep 10th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1124075700 | NPPES |
Illinois | Other | 81260006 | PTAN |
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