Individual
BERNARDO DUARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1841 W. ARMY TRAIL RD, CHICAGO, IL 60101
(630) 472-1111
(773) 564-5186
Mailing address
PO BOX 2143, HIGHLAND PARK, IL 60035-8143
(630) 472-1111
(630) 472-1125
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036047859
IL
2086X0206X
Surgical Oncology Physician
036047859
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047859
—
IL
01
—
2221777
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/06/2006
Last updated
10/09/2015
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