Individual
PASCUAL BAQUIRAN SALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11101 S STATE ST, CHICAGO, IL 60628-4206
(773) 821-7515
(773) 821-6970
Mailing address
11101 S STATE ST, CHICAGO, IL 60628-4206
(773) 821-7515
(773) 821-6970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036046316
IL
208600000X
Surgery Physician
Primary
036046316
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046316
—
IL
Enumeration date
07/07/2006
Last updated
07/02/2010
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