Irabagon, Nenita

Irabagon, Nenita is an individual health care provider with primary practice located at 6250 S Archer Ave , Chicago IL 60638-2639. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Irabagon, Nenita can be contacted via phone (773) 581-8400.

Contact Information

Primary practice address
6250 S Archer Ave Chicago IL 60638-2639
Phone: (773) 581-8400
Fax: (773) 581-9577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36091558 Illinois

Profile Details

NPI number 1104885466
LBN Legal business name Irabagon, Nenita
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jan 21st, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104885466 NPPES
Illinois Other 110129812 RAIL ROAD MEDICARE
Illinois Other 1607717 RAIL ROAD MEDICARE
Illinois MEDICAID 036091558 RAIL ROAD MEDICARE

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