Organization
EDGAR RIOS M.D., S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO R RIOS MD (UROLOGY)
(773) 521-1100
Entity
Organization
Contact information
Practice address
4152 W 26TH ST, CHICAGO, IL 60623-4312
(773) 521-1100
(773) 521-9032
Mailing address
203 MIDWEST CLUB PKWY, OAK BROOK, IL 60523-2508
(773) 521-1100
(773) 521-9032
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036048072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021608512
BLUE CROSS NUMBER
IL
05
—
036048072
—
IL
01
—
1881957405
NPI
IL
Enumeration date
05/15/2007
Last updated
08/09/2024
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