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NPI Code Detail

MEDICARE: JOSEPH ANTHONY LAGATTUTA JR. MD

MEDICARE: JOSEPH ANTHONY LAGATTUTA JR. 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
1207RG0100XGastroenterology Physician036065102IL

General Provider Information

NPI Number : 1053388520
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH ANTHONY LAGATTUTA JR. MD
Provider Business Mailing Address
First Line : 630 E NORTH AVE
Second Line : DEPT OF GI
City : CAROL STREAM
State : IL
Zip : 60188
Country : US
Telephone Number : 630-458-5300
Fax Number : 630-307-2751
Provider Business Practice Location Address
First Line : 630 E NORTH AVE DEPT OF
Second Line :
City : CAROL STREAM
State : IL
Zip : 60188-2127
Country : US
Telephone Number : 630-458-5300
Fax Number : 630-307-2751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 03/22/2021

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