Organization
BURGOS FUENTES SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL A BURGOS M.D. (PRESIDENT)
(630) 422-1917
Entity
Organization
Contact information
Practice address
229 W GRAND AVE STE QW, BENSENVILLE, IL 60106-3373
(630) 422-1917
(630) 422-7226
Mailing address
229 W GRAND AVE STE QW, BENSENVILLE, IL 60106-3373
(630) 422-1917
(630) 422-7226
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036103673
IL
Other
Enumeration date
11/08/2006
Last updated
12/01/2011
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