Healthcare Provider Details

I. General information

NPI: 1164538161
Provider Name (Legal Business Name): SAM F FLOSI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16609 107TH ST
ORLAND PARK IL
60467-9016
US

IV. Provider business mailing address

22 PRAIRE LN
ORLAND PARK IL
60467-7222
US

V. Phone/Fax

Practice location:
  • Phone: 708-645-8080
  • Fax: 708-645-8081
Mailing address:
  • Phone: 708-226-9646
  • Fax: 708-226-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: