SUPREME MD INC. NPI 1366032724

NPI Information

  • NPI: 1366032724
  • Provider Name: SUPREME MD INC.
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • Address: 5737 N TALMAN AVE APT 2
    CHICAGO, IL
    ZIP 60659
  • Phone: (773) 329-6545

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NPI Details

SUPREME MD INC. is a geriatric medicine family medicine in Chicago, IL. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. SUPREME MD INC. NPI is 1366032724. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5737 N TALMAN AVE APT 2
CHICAGO, IL
ZIP 60659-097
Phone: (773) 329-6545

The provider's authorized official is Cesario Boligor .
The authorized official title is Ceo and has the following contact phone number (773) 329-6545.

The enumeration date for this NPI number is 1/20/2021 and was last updated on 1/20/2021.

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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3251F00000XHome InfusionNo
4207QG0300XFamily MedicineGeriatric MedicineYes

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: 11/21/2025

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