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Individual

DR. GUSTAVO RICARDO SANCHEZ-VARGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
523 W GALENA BLVD, AURORA, IL 60506-3847
(630) 966-9701
(630) 966-9702
Mailing address
523 W GALENA BLVD, AURORA, IL 60506-3847
(630) 966-9701
(630) 966-9702

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098710
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036098710
IL
01
11308130
CAQH
IL
01
4526065
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/04/2007
Last updated
05/14/2008
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