Provider Demographics
NPI:1912173675
Name:ARTURO OLIVERA JR.,M.D. LTD.
Entity Type:Organization
Organization Name:ARTURO OLIVERA JR.,M.D. LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:847-651-2304
Mailing Address - Street 1:770 E NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3464
Mailing Address - Country:US
Mailing Address - Phone:847-651-2304
Mailing Address - Fax:847-724-0675
Practice Address - Street 1:770 E NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3464
Practice Address - Country:US
Practice Address - Phone:847-651-2304
Practice Address - Fax:847-724-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073024207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001628796OtherILLINOIS BCBS
IL036073024Medicaid
IL0001628796OtherILLINOIS BCBS
IL208769Medicare PIN