Mejicano, Rodolfo J

Mejicano, Rodolfo J is an sole proprietor health care provider with primary practice located at 9641 W 153Rd St 48, Orland Park IL 60462-3775. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mejicano, Rodolfo J can be contacted via phone (708) 403-0431.

Contact Information

Primary practice address
9641 W 153Rd St 48 Orland Park IL 60462-3775
Fax: (708) 403-0699
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036078539 Illinois

Profile Details

NPI number 1932107430
LBN Legal business name Mejicano, Rodolfo J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2005
Last updated Apr 11th, 2017 - about 7 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 1932107430 NPPES
Illinois MEDICAID 036078539

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