Provider Demographics
NPI:1962493064
Name:SILVA, ROGELIO GABRIEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGELIO
Middle Name:GABRIEL
Last Name:SILVA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:4400 W 95TH ST STE 310
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2660
Practice Address - Country:US
Practice Address - Phone:708-684-9230
Practice Address - Fax:708-684-9231
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2024-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA35020207RG0100X
IL036106490207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106490Medicaid
ILK30566Medicare PIN
ILH73891Medicare UPIN