Provider Demographics
NPI:1164445854
Name:FLORES, JAVIER (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4952 W IRVING PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2693
Mailing Address - Country:US
Mailing Address - Phone:773-942-6141
Mailing Address - Fax:866-707-2267
Practice Address - Street 1:4952 W IRVING PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2693
Practice Address - Country:US
Practice Address - Phone:773-942-6141
Practice Address - Fax:866-707-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116087202K00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty