Provider Demographics
NPI:1548560741
Name:MORALES LA MADRID, ANDRES EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:EDUARDO
Last Name:MORALES LA MADRID
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5841 S MARYLAND AVE
Mailing Address - Street 2:MC 4060
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-702-6808
Mailing Address - Fax:773-834-1329
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC 4060
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-6808
Practice Address - Fax:773-834-1329
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
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Provider Licenses
StateLicense IDTaxonomies
IL125.0556382080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology