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General NPI Number Information
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NPI Number | 1164557666
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Entity Type | Organization
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Legal Business Name | GLORIA CARUSO M.D.P.C
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 473 W ARMY TRAIL RD STE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-894-1445
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Fax |
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Provider Business Mailing Address
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Address Line | 473 W ARMY TRAIL RD STE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-894-1445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLORIA JEAN CARUSO
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Credential | M.D.
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Telephone | 630-894-1445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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