Provider Demographics
NPI:1407038805
Name:ROLANDO SAJOR MD SC
Entity Type:Organization
Organization Name:ROLANDO SAJOR MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:SALVATIERRA
Authorized Official - Last Name:SAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-378-8100
Mailing Address - Street 1:4801 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644-2609
Mailing Address - Country:US
Mailing Address - Phone:773-378-8100
Mailing Address - Fax:773-378-8100
Practice Address - Street 1:4801 W LAKE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-2609
Practice Address - Country:US
Practice Address - Phone:773-378-8100
Practice Address - Fax:773-378-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center