Individual
DR. MARIO REY SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 PERIMETER DR STE 620, SCHAUMBURG, IL 60173-5056
(847) 619-5500
Mailing address
2015 SPRING RD STE 300, OAK BROOK, IL 60523-3944
(630) 725-2700
(630) 725-2873
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036114108
IL
208600000X
Surgery Physician
35099584
OH
208600000X
Surgery Physician
M7587
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0068422
—
OH
01
—
340731
GROUP MEDICARE PTAN
TX
01
—
340739
GROUP MEDICARE PTAN
TX
01
—
DV0090
MEDICARE RAILROAD GROUP PTAN
TX
01
—
P01574620
MEDICARE RAILROAD INDIVIDUAL PTAN
TX
Enumeration date
06/14/2007
Last updated
01/11/2022
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