Doctor Name: | DR. ESMERALDO E CORDOVA |
NPI Number: | 1003837071 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 03652477 |
Business Practice Address: | 3625 W Roosevelt Rd Chicago, IL - 60624 |
Business Phone Number: | 7735220110 |
Business Fax Number: | 6309648397 |
Mailing Address: | 7317 Bayberry Lane, DARIEN |
State: | IL |
Postal Code: | 60561 |
Phone Number: | 6309648376 |
Fax Number: | 6309648397 |
NPI Enumeration Date: | 07/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 03652477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |