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NPI Code Detail

MEDICARE: GUSTAVO E OROZA-HENNERS M.D.

MEDICARE: GUSTAVO E OROZA-HENNERS M.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
1208000000XPediatrics Physician036-083375IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437228806
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUSTAVO E OROZA-HENNERS M.D.
Provider Business Mailing Address
First Line : 1205 N MARION ST
Second Line :
City : OAK PARK
State : IL
Zip : 60302-1253
Country : US
Telephone Number : 312-666-5455
Fax Number :
Provider Business Practice Location Address
First Line : 1859 S BLUE ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3012
Country : US
Telephone Number : 312-666-5455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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