Miravalle, Augusto

Miravalle, Augusto is an individual health care provider with primary practice located at 1725 W Harrison St Ste 309 , Chicago IL 60612-3844. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Miravalle, Augusto can be contacted via phone (312) 942-8011.

Contact Information

Primary practice address
1725 W Harrison St Ste 309 Chicago IL 60612-3844
Phone: (312) 942-8011
Fax: (970) 226-6707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036118267 Illinois
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 0047246 Colorado

Profile Details

NPI number 1629216627
LBN Legal business name Miravalle, Augusto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2009
Last updated Jul 28th, 2023 - about 3 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 1629216627 NPPES
Florida MEDICAID 020217800

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