Provider Demographics
NPI:1013254341
Name:HECTOR L. SALCEDO M.D. S.C.
Entity Type:Organization
Organization Name:HECTOR L. SALCEDO M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-227-3132
Mailing Address - Street 1:4455 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2628
Mailing Address - Country:US
Mailing Address - Phone:773-227-3132
Mailing Address - Fax:773-227-3309
Practice Address - Street 1:3132 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-8415
Practice Address - Country:US
Practice Address - Phone:773-227-3132
Practice Address - Fax:773-227-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036128912207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty