Roque-Ponton Medical Group, S.C.

LBN: Roque-Ponton Medical Group, S.C.
Roque-Ponton Medical Group, S.C. is an health care organization with primary practice located at 2740 W Foster Ave Suite 313, Chicago IL 60625-3500. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is the primary health care specialty. Roque-Ponton Medical Group, S.C. can be contacted via phone (773) 271-4455, or through Roque, David Lopez via phone (773) 271-3344.

Contact Information

Primary practice address
2740 W Foster Ave Suite 313 Chicago IL 60625-3500
Phone: (773) 271-4455
Fax: (773) 271-4540
Website:
Map and Directions
Authorized official contact:
Name: Roque, David Lopez Doctor of Medicine (MD)
Phone: (773) 271-3344

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1457570459
LBN Legal business name Roque-Ponton Medical Group, S.C.
DBA Doing business as
Authorized official Roque, David Lopez Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457570459 NPPES
Wisconsin Other 38340020 FAMILY PRACTICE
Wisconsin Other 5348 FAMILY PRACTICE

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