Jorge, Juaquito Mario
Jorge, Juaquito Mario is an individual health care provider with primary practice located at 1950 N Harlem Ave , Elmwood Park IL 60707-3717. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jorge, Juaquito Mario can be contacted via phone (708) 453-6800.Contact Information
Primary practice address
1950 N Harlem Ave
Elmwood Park IL 60707-3717
Phone: (708) 453-6800
Fax: (708) 453-3985
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036129844 | Illinois |
Profile Details
| NPI number | 1629206511 |
|---|---|
| LBN Legal business name | Jorge, Juaquito Mario |
| Credentials | MD, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2009 |
| Last updated | Oct 18th, 2022 - about 2 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 | 1629206511 | NPPES |
| Illinois | MEDICAID | 36129844 |
Popular Providers
-
Johnson, Carl Winston
6703 W 159Th Street Suite 110, Tinley Park IL 60477 -
Nash, Donald D
610 S Maple Ave Suite 2900, Oak Park IL 60304-1091 -
Stear, Timothy Jordan
1950 N Harlem Ave , Elmwood Park IL 60707-3717 -
Govekar, Henry Robert
1950 N Harlem Ave , Elmwood Park IL 60707-3717 -
Tiesenga, Frederick M
1950 N Harlem Ave , Elmwood Park IL 60707-3717 -
Fiorucci, Michael R
2850 W 95Th St Suite 306, Evergreen Park IL 60805-2735 -
Hill, Mark Nolan
625 Roger Williams Ave Suite 102, Highland Park IL 60035-4840 -
Diniotis, Athanasios D.
1950 N Harlem Ave , Elmwood Park IL 60707-3717