Alfonso S Bardales
General Practice Physician Gynecologist
3339 W 55th St
Chicago
, Illinois 60632-3249
Alfonso S Bardales
General Practice Physician Gynecologist
3339 W 55th St
Chicago
, Illinois 60632-3249
(773) 278-0724
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About
Features
Specialties
- Gynecologist
- General Practice Physician
Languages spoken
- English
Location
First Address
- Alfonso S Bardales
- 2551 N Milwaukee Ave
- Chicago, IL
- Zip : 60647-2629
- Phone : (773) 278-0724
Second Address
- Alfonso S Bardales
- 3339 W 55th St
- Chicago, IL
- Zip : 60632-3249
- Phone : (773) 471-3600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207VG0400X | Gynecologist | 036056659 | IL |
| Y | 208D00000X | General Practice Physician | 036056659 | IL |
National Provider Identifier
| NPI | 1124075700 |
|---|---|
| Provider Name | Alfonso S Bardales |
| First Address | Chicago, IL 60647-2629 |
| Second Address | Chicago, IL 60632-3249 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/05/2006 |
| Last Update Date | 10/09/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 81260006 | PTAN (01) | IL |
| C45422 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.