Healthcare Provider Details
I. General information
NPI: 1194773754
Provider Name (Legal Business Name): COSMIN DOBRESCU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/05/2006
Last Update Date: 11/17/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1658 N MILWAUKEE AVE STE B316
CHICAGO IL
60647-6905
US
IV. Provider business mailing address
1658 N MILWAUKEE AVE STE B316
CHICAGO IL
60647-6905
US
V. Phone/Fax
- Phone: 205-520-4101
- Fax:
- Phone: 205-520-4101
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 01081319A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 330415 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 35.096758 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 54864-20 |
| License Number State | WI |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 29944 |
| License Number State | WV |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | MD.37367 |
| License Number State | AL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | MD437759 |
| License Number State | PA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | A-121057 |
| License Number State | CA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 064361 |
| License Number State | GA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | ME120059 |
| License Number State | FL |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 036.127050 |
| License Number State | IL |
| # 12 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | T2356 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
