Individual
DR. JAIME RICARDO ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 SUPERIOR STREET, SUITE 309, MELROSE PARK, IL 60160-4156
(708) 343-0420
(708) 343-4290
Mailing address
1111 SUPERIOR STREET, SUITE 309, MELROSE PARK, IL 60160-4156
(708) 343-0420
(708) 343-4290
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36042797
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021623191
BC BS
IL
Enumeration date
03/01/2007
Last updated
07/08/2007
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