Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 036-112813 | IL |
NPI | 1003810953 |
---|---|
Provider Name | Dr. Arcadio Hilario Valenzuela Pomer |
First Address | Des Plaines, IL 60016-1236 |
Second Address | Des Plaines, IL 60016-1236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 20/01/2022 |