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Individual

DR. ALFREDO ESTEVAN RUMILLA II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2554 W FULLERTON AVE, CHICAGO, IL 60647-3148
(773) 342-8888
(773) 342-6257
Mailing address
2554 W FULLERTON AVE, CHICAGO, IL 60647-3148
(773) 687-9490
(773) 687-9637

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-095178
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0021623247
ILLINOIS BLUE CROSS/BLUE
IL
Enumeration date
10/20/2006
Last updated
11/10/2020
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