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NPI Code Detail

MEDICARE: ALFONSO DELGRANADO M.D.

MEDICARE: ALFONSO DELGRANADO 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
1207VG0400XGynecology Physician036045416IL

General Provider Information

NPI Number : 1720157977
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFONSO DELGRANADO M.D.
Provider Business Mailing Address
First Line : 13000 MAPLE AVE
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-2318
Country : US
Telephone Number : 708-385-6100
Fax Number : 708-385-2051
Provider Business Practice Location Address
First Line : 13000 MAPLE AVE
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-2318
Country : US
Telephone Number : 708-385-6100
Fax Number : 708-385-2051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 05/07/2012

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