Provider Demographics
NPI:1720454713
Name:SALGADO, HILDA A
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:A
Last Name:SALGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17901 GOVERNORS HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1144
Mailing Address - Country:US
Mailing Address - Phone:708-957-0220
Mailing Address - Fax:
Practice Address - Street 1:17901 GOVERNORS HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1144
Practice Address - Country:US
Practice Address - Phone:708-957-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant