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WILFREDO A GRANADA MD LTD NPI 1205017597


NPI Information

NPI: 1205017597
Provider Name: WILFREDO A GRANADA MD LTD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2629 SHERIDAN RD
SUITE C
ZION, IL
ZIP 60099
Phone: (847) 872-5556
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WILFREDO A GRANADA MD LTD is a primary care clinic center in Zion, IL. WILFREDO A GRANADA MD LTD NPI is 1205017597. The provider is registered as an organization entity type.

The provider's business location address is:

2629 SHERIDAN RD
SUITE C
ZION, IL
ZIP 60099-629
Phone: (847) 872-5556
Fax: (847) 872-5570

The provider's authorized official is Wilfredo Granada .
The authorized official title is Physician and has the following contact phone number (847) 872-5556.

The enumeration date for this NPI number is 11/15/2007 and was last updated on 1/31/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
121604808OTHERILLINOISBLUE CROSS
2C44602MEDICARE UPINILLINOIS
3212858OTHERILLINOISMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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