Provider Demographics
NPI:1912973900
Name:GARCIA, ARNEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNEL
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 HOLY CROSS LN
Mailing Address - Street 2:
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-3510
Mailing Address - Country:US
Mailing Address - Phone:618-526-7271
Mailing Address - Fax:618-526-7313
Practice Address - Street 1:9401 HOLY CROSS LN
Practice Address - Street 2:
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-3510
Practice Address - Country:US
Practice Address - Phone:618-526-7271
Practice Address - Fax:618-526-7313
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01407524OtherBLUE CROSS BLUE SHIELD
IL036092839Medicaid
393060Medicare ID - Type Unspecified
IL01407524OtherBLUE CROSS BLUE SHIELD