Provider Demographics
NPI:1902990922
Name:RICAURTE, FRANCISCO ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ANTONIO
Last Name:RICAURTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8741 AVERS AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2203
Mailing Address - Country:US
Mailing Address - Phone:847-677-3742
Mailing Address - Fax:
Practice Address - Street 1:1368 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2149
Practice Address - Country:US
Practice Address - Phone:773-235-2882
Practice Address - Fax:773-278-6235
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
471840Medicare ID - Type Unspecified