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Organization
PONOS CARE ILLINOIS, PLLC
Active
Organization
PONOS CARE ILLINOIS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERTO BULTRON MD (PRESIDENT)
(818) 856-6696
Entity
Organization
Contact information
Practice address
1538 W JACKSON BLVD STE 200, CHICAGO, IL 60607-5304
(312) 610-1000
(872) 351-9638
Mailing address
1538 W JACKSON BLVD STE 200, CHICAGO, IL 60607-5304
(312) 610-1000
(872) 351-9638
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
03/11/2026
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