Basic Information
Provider Information
NPI: 1083230957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VILLAFRANCA
FirstName: ALEJANDRO
MiddleName: JOSE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3249 S. OAK PARK AVE MACNEAL HOSPITAL
Address2:  
City: BERWYN
State: IL
PostalCode: 60402
CountryCode: US
TelephoneNumber: 7087833401
FaxNumber:  
Practice Location
Address1: 3722 SOUTH HARLEM AVE. MACNEAL CENTER FOR INTERNAL MEDI
Address2: SUITE LL34
City: RIVERSIDE
State: IL
PostalCode: 60546
CountryCode: US
TelephoneNumber: 7087836566
FaxNumber: 7087836567
Other Information
ProviderEnumerationDate: 06/17/2020
LastUpdateDate: 07/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125.076779ILY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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