Alfonso S Bardales, M.D

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036056659 Issued in IL

Practice address

3339 W 55TH St
Chicago, IL 60632-3249

Phone

(773) 471-3600

NPI assigned

May 28, 2006

Last updated

Sep 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1124075700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472629",
            "telephone_number": "773-278-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3339 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606323249",
            "telephone_number": "773-471-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDALES",
        "first_name": "ALFONSO",
        "middle_name": "S",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036056659",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036056659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Henoch Barch
• Rebecca Leigh Barchfeld, CRNA
• Holly Ann Barczak, LCPC
• Tomasz Roman Barczyk
• Andrea Bardac
• Patricia A. Bardenett, L.C.S.W.
• Cristina Bardita, MD, PHD
• Anne Bardo
• Nicole Bardoczi, CRNA
• Bare Conversations, PLLC

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.