Juaquito Mario Jorge MD, MS

NPI 1629206511 - Surgery - 208600000X

NPI Details
NPI 1629206511
Gender Male
Enumeration Date 06/30/2009
Last Updated 11/19/2012
Entity Type Individual
Active Over 7 years ago
Practice Location
1410 W POLK ST, APT 2 FRONT
NONE
CHICAGO IL, 60607, US
Phone (312) 523-1424
Fax
Business Location
1410 W POLK ST APT 2
NONE
CHICAGO IL, 60607-4151, US
Phone (312) 523-1424
Fax
Toxanomy
Taxonomy Code 208600000X
License State Illinois
License Number 036129844
Remove 1629206511 NPI Number
 

According to our database, Dr. Juaquito Mario Jorge MD, MS NPI is 1629206511, taxonomy code is 208600000X and license number is 036129844, license state is located at Illinois. Juaquito Mario Jorge MD, MS physically located at 1410 W Polk St, Apt 2 Front, Chicago IL, 60607. NPI Number Juaquito Mario Jorge MD, MS has the Individual type.

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1629206511 NPI number is provided on an as is basis without warranty of any kind. 1629206511 is maintained by the National Plan & Provider Enumeration System. The contents of Juaquito Mario Jorge MD, MS are for informational purposes only.