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General NPI Number Information
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NPI Number | 1568764777
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Entity Type | Organization
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Legal Business Name | LUIS GONZALEZ-OROZCO MD SC
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 494 LEE ST
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City | DES PLAINES
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State | IL
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Zip | 60016-4607
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Country | US
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Telephone | 847-297-1515
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Fax | 847-297-3390
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Provider Business Mailing Address
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Address Line | 494 LEE ST
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City | DES PLAINES
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State | IL
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Zip | 60016-4607
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Country | US
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Telephone | 847-297-1515
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Fax | 847-297-3390
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS GONZALEZ OROZCO
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Credential | MD
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Telephone | 847-297-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036-055907
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License Number State | IL
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