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Individual

MRS. ESTRELLITA VELEZ JO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10604 SOUTHWEST HIGHWAY, STE 107, CHICAGO RIDGE, IL 60415-2717
(708) 422-0636
(708) 424-2164
Mailing address
10604 SOUTHWEST HIGHWAY, STE 107, CHICAGO RIDGE, IL 60415-2717
(708) 422-0636
(708) 424-2164

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036105855
IL
207RP1001X
Pulmonary Disease Physician
Primary
036105855
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01632457
BLUE CROSS BLUE SHIELD
IL
05
036105855
IL
01
P00254382
RAILROAD MEDICARE
IL
01
R030131
RAILROAD MEDICARE
IL
Enumeration date
04/12/2006
Last updated
06/08/2018
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