Individual
ADALBERTO CAMPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1431 N WESTERN AVE, SUITE 506, CHICAGO, IL 60622
(773) 645-1000
(773) 645-1069
Mailing address
1431 N WESTERN AVE, SUITE 506, CHICAGO, IL 60622
(773) 645-1000
(773) 645-1069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036064958
IL
207RC0000X
Cardiovascular Disease Physician
036064958
IL
207RI0011X
Interventional Cardiology Physician
Primary
036064958
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064958
—
IL
01
—
110144723
RAILROAD MEDICARE
—
01
—
31602366
BCBS
—
Enumeration date
12/27/2006
Last updated
10/09/2020
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