Individual
MARCOS RAFAEL HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 118, CHICAGO, IL 60612-3817
(312) 942-4817
Mailing address
1725 W HARRISON ST STE 118, CHICAGO, IL 60612-3817
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
125080112
IL
Other
Enumeration date
07/10/2022
Last updated
07/12/2022
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