Bardales, Alfonso S

Bardales, Alfonso S is an sole proprietor health care provider with primary practice located at 3339 W 55Th St , Chicago IL 60632-3249. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Bardales, Alfonso S can be contacted via phone (773) 471-3600.

Contact Information

Primary practice address
3339 W 55Th St Chicago IL 60632-3249
Phone: (773) 471-3600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 036056659 Illinois
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 036056659 Illinois

Profile Details

NPI number 1124075700
LBN Legal business name Bardales, Alfonso S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2006
Last updated Sep 10th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124075700 NPPES
Illinois Other 81260006 PTAN

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