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NPI Code Detail

MEDICARE: MRS. OLEZIA COMSULEA M.D., PH.D.

MEDICARE: MRS. OLEZIA COMSULEA M.D., PH.D.
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
1207L00000XAnesthesiology PhysicianIL

General Provider Information

NPI Number : 1164468021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLEZIA COMSULEA M.D., PH.D.
Provider Business Mailing Address
First Line : 8263 HESS AVE
Second Line :
City : LA GRANGE
State : IL
Zip : 60525-5219
Country : US
Telephone Number : 708-246-2381
Fax Number :
Provider Business Practice Location Address
First Line : 2929 S ELLIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3395
Country : US
Telephone Number : 708-791-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 09/27/2007

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Directions to “ MRS. OLEZIA COMSULEA M.D., PH.D.” Practice Location

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