Individual
DR. EDGAR RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4152 W 26TH ST, CHICAGO, IL 60623-4312
(773) 521-1100
(773) 521-9032
Mailing address
203 MIDWEST CLUB PKWY, OAK BROOK, IL 60523-2508
(773) 521-1100
(773) 521-9032
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036048072
IL
2088P0231X
Pediatric Urology Physician
036048072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021608440
BC/BS PROVIDER NUMBER
IL
05
—
036048072
—
IL
Enumeration date
10/27/2006
Last updated
12/15/2017
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