Individual
AUSENCIO NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1841 W ARMY TRAIL RD, R, ADDISON, IL 60101-1901
(630) 238-9235
(630) 238-0426
Mailing address
1841 W ARMY TRAIL RD, R, ADDISON, IL 60101-1901
(630) 238-9235
(630) 238-0426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036078267
IL
208000000X
Pediatrics Physician
036078267
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02205538
BCBS PROVIDER NUMBER
IL
05
—
036078267
—
IL
01
—
363950044
TAXID
IL
01
—
CF9448
RAILROAD MEDICARE GROUP #
IL
Enumeration date
02/07/2007
Last updated
05/23/2013
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