Lora-Mir, Fausto R.

Lora-Mir, Fausto R. is an individual health care provider with primary practice located at 2023 Royal Blvd Suite A, Elgin IL 60120. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lora-Mir, Fausto R. can be contacted via phone (847) 931-7274.

Contact Information

Primary practice address
2023 Royal Blvd Suite A Elgin IL 60120
Phone: (847) 931-7274
Fax: (847) 931-7159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036084051 Illinois

Profile Details

NPI number 1104875434
LBN Legal business name Lora-Mir, Fausto R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Oct 3rd, 2008 - about 16 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 1104875434 NPPES
Illinois MEDICAID 036084051
Illinois Other 0005767635
Illinois Other 0163557
Illinois Other 00001384212 18

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