1700864550 NPI number — FRANCIS Q ALMEDA MD

Table of content: FRANCIS Q ALMEDA MD (NPI 1700864550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700864550 NPI number — FRANCIS Q ALMEDA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALMEDA
Provider First Name:
FRANCIS
Provider Middle Name:
Q
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700864550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 W 156TH ST STE 305
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARVEY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60426-4264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-331-2200
Provider Business Mailing Address Fax Number:
708-331-8015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 W 156TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARVEY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-331-2200
Provider Business Practice Location Address Fax Number:
708-331-8015
Provider Enumeration Date:
01/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  036097414 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0360974143 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00016633 . This is a "PALMETTO RR MEDICARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".