Individual
CHRISTIAN A RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-2000
Mailing address
1950 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-0200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.082464
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.082464
IL
Other
Enumeration date
06/06/2023
Last updated
08/27/2023
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