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NPI 1891770624

NPI 1891770624 : DENNIS S. ASENSIO M.D. : LISLE, IL

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General NPI Number Information
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    NPI Number           |    1891770624
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    Entity Type          |    Individual 
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    Provider Name        |    DENNIS S. ASENSIO M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/14/2005
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    Last Update Date     |    12/01/2010
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Provider Practice Location Address
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    Address Line         |    2765 MAPLE AVE 
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    City                 |    LISLE
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    State                |    IL
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    Zip                  |    60532-3280
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    Country              |    US
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    Telephone            |    630-579-9817
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    Fax                  |    630-579-9846
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Provider Business Mailing Address
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    Address Line         |    2765 MAPLE AVE 
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    City                 |    LISLE
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    State                |    IL
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    Zip                  |    60532-3280
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    Country              |    US
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    Telephone            |    630-579-9817
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    Fax                  |    630-579-9846
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    036-075848
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    License Number State |    IL
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