Vergara, Humberto
Vergara, Humberto is an individual health care provider with primary practice located at 1431 N Western Ave Suite 205, Chicago IL 60622-1797. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Vergara, Humberto can be contacted via phone (773) 278-4811.Contact Information
Primary practice address
1431 N Western Ave Suite 205
Chicago IL 60622-1797
Phone: (773) 278-4811
Fax: (773) 278-5920
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 036-072013 | Illinois |
Profile Details
| NPI number | 1124004262 |
|---|---|
| LBN Legal business name | Vergara, Humberto |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2005 |
| Last updated | Aug 31st, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124004262 | NPPES |
| Illinois | MEDICAID | 036072013 |
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