Individual
JANUARIO PURISIMA ESTRADA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1585 BARRINGTON RD, #306, HOFFMAN ESTATES, IL 60194-1090
(847) 844-3199
(847) 844-1536
Mailing address
PO BOX 64568, PHOENIX, AZ 85082-4568
(630) 288-6200
(855) 781-4084
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036074492
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021623344
BCBS PROVIDER ID
IL
05
—
036074492
—
IL
01
—
110196734
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
08/20/2019
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