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Organization

BLUE ISLAND MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HECTOR LUIS FLORES M.D. (PRESIDENT)
(773) 278-2998
Entity
Organization

Contact information

Practice address
1802 W CHICAGO AVE, SUITE 2, CHICAGO, IL 60622
(773) 278-2998
Mailing address
1802 W CHICAGO AVE, SUITE 2, CHICAGO, IL 60622
(773) 278-2998

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036090820
IL
208D00000X
General Practice Physician
Primary
036090820
IL

Other

Enumeration date
10/22/2010
Last updated
10/22/2010
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