Individual
EILEEN ANNE VICALDO ALONTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 S DAMEN AVE., CHICAGO, IL 60612
(312) 569-6043
(701) 234-7230
Mailing address
820 S DAMEN AVE., CHICAGO, IL 60612
(312) 569-6043
(312) 569-8788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036151087
IL
207R00000X
Internal Medicine Physician
12202
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16715
—
ND
Enumeration date
10/17/2008
Last updated
11/16/2023
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