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Organization

MARIO A SALAZAR MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIO A SALAZAR M.D. (PHYSICIAN)
(773) 237-7795
Entity
Organization

Contact information

Practice address
3048 N HARLEM AVE, CHICAGO, IL 60634-4704
(773) 237-7795
Mailing address
3048 N HARLEM AVE, CHICAGO, IL 60634-4704

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036049655
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036049655
IL
01
21605529
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/15/2010
Last updated
07/19/2010
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