Individual
DR. FIDEL ECHEVARRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0801
Mailing address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0801
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036100897
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036100897
BLUE SHIELD
IL
05
—
036100897
—
IL
Enumeration date
09/28/2006
Last updated
12/04/2007
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