Individual
SIMEON A SEVANDAL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3339 W 55TH ST, CHICAGO, IL 60632
(773) 471-3600
(773) 471-3602
Mailing address
3339 W 55TH ST, CHICAGO, IL 60632
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
3654903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3654903
—
IL
Enumeration date
09/01/2005
Last updated
09/30/2011
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