Provider Demographics
NPI:1033241880
Name:THE CHEST CENTER
Entity Type:Organization
Organization Name:THE CHEST CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-788-5864
Mailing Address - Street 1:2508 25TH ST STE B
Mailing Address - Street 2:BLACKHAWK MEDICAL BLDG.
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5419
Mailing Address - Country:US
Mailing Address - Phone:309-788-5864
Mailing Address - Fax:309-788-5868
Practice Address - Street 1:2508 25TH ST STE B
Practice Address - Street 2:BLACKHAWK MEDICAL BLDG.
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5419
Practice Address - Country:US
Practice Address - Phone:309-788-5864
Practice Address - Fax:309-788-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C44930Medicare UPIN