Healthcare Provider Details

I. General information

NPI: 1033119292
Provider Name (Legal Business Name): DAVID P TOJO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 DEMPSTER ST STE 301
PARK RIDGE IL
60068-1186
US

IV. Provider business mailing address

1875 DEMPSTER ST STE 301
PARK RIDGE IL
60068-1186
US

V. Phone/Fax

Practice location:
  • Phone: 847-685-1000
  • Fax: 847-685-6685
Mailing address:
  • Phone: 847-685-1000
  • Fax: 847-685-6685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: