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Individual

ELEAZAR E CALERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4324 W 63RD ST, CHICAGO, IL 60629-5012
(773) 767-3171
(773) 767-9227
Mailing address
100 W CHICAGO AVE, STE F, EAST CHICAGO, IN 46312-3261
(219) 703-2583
(219) 703-6749

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036078184
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110201552
PALMETTO
IL
01
1720250129
PALMETTO GROUP NPI
IL
Enumeration date
02/12/2007
Last updated
06/13/2019
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