| Supreme MD | |
|
5737 N Talman Ave Apt 2 Chicago IL 60659-5097 | |
| (773) 329-6545 | |
| Not Available |
| Full Name | Supreme MD |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 5737 N Talman Ave Apt 2, Chicago, Illinois |
| Authorized Official Name and Position | Cesario Boligor (CEO) |
| Authorized Official Contact | 7733296545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supreme MD 5737 N Talman Ave Apt 2 Chicago IL 60659-5097 Ph: (773) 329-6545 | Supreme MD 5737 N Talman Ave Apt 2 Chicago IL 60659-5097 Ph: (773) 329-6545 |
| NPI Number | 1366032724 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 01/20/2021 |
| Certification Date | 01/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366032724 | NPI | - | NPPES |
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