Most Relevant Information
Provider Data
| NPI Number: | 1003426743 |
| Provider Name: | CARLOS ANDRES RUEDA MANTILLA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 125075440 |
Most Important Dates
| Enumeration Date: | 08/07/2020 |
| Last Updated: | 08/07/2020 |
Provider Practice Location
4646 N MARINE DR
CHICAGO
IL
606405759
Practice Location Phone/Fax
| Phone: | 3128261105 |
| Fax: |
Provider Mailing Location
4250 N MARINE DR APT 2333
CHICAGO
IL
606131747
Provider Mailing Phone/Fax
| Phone: | 3128261105 |
| Fax: |
Suggested EMR
Internist EMR