Provider Demographics
NPI:1659593408
Name:VELARDE, HUGO R (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:R
Last Name:VELARDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1064 SAXONY DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4049
Mailing Address - Country:US
Mailing Address - Phone:847-433-6358
Mailing Address - Fax:312-770-3120
Practice Address - Street 1:2233 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3043
Practice Address - Country:US
Practice Address - Phone:312-491-5098
Practice Address - Fax:312-770-3120
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILAV3738119OtherDEA