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NPI Code Detail

MEDICARE: STEVE WARREN HANDOYO MD

MEDICARE: STEVE WARREN HANDOYO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036-116788IL
22080P0201XPediatric Allergy/Immunology Physician036116788IL

General Provider Information

NPI Number : 1033296801
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVE WARREN HANDOYO MD
Provider Business Mailing Address
First Line : 150 HARVESTER DR STE 300
Second Line :
City : BURR RIDGE
State : IL
Zip : 60527-5965
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number : 773-702-6169
Fax Number : 773-834-8120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 12/02/2024

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