Individual
LORITZ CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2025 E NEWPORT AVE, SUITE 217, MILWAUKEE, WI 53211-2906
(414) 961-4426
(414) 961-3393
Mailing address
PO BOX 806338, CHICAGO, IL 60680-4124
(312) 593-4236
(773) 582-1380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036087770
IL
208M00000X
Hospitalist Physician
Primary
036087770
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031601474
BLUE SHIELD
IL
05
—
036087770
—
IL
01
—
P00225879
RAILROAD MEDICARE
—
Enumeration date
07/19/2006
Last updated
01/20/2022
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