1780816488 NPI number — UNIVERSAL FAMILY CONNECTION, INC.

Table of content: DR. FRANCIS RAYMUND RIVERO CARANDANG M.D. (NPI 1780678334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780816488 NPI number — UNIVERSAL FAMILY CONNECTION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSAL FAMILY CONNECTION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1780816488
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1350 W 103RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60643-2302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-881-1711
Provider Business Mailing Address Fax Number:
773-881-3124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1350 W 103RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60643-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-881-1711
Provider Business Practice Location Address Fax Number:
773-881-3124
Provider Enumeration Date:
08/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
773-881-1711

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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