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Organization
PRISCO I. OLAYA JR. M.D. S.C.
Active
Organization
PRISCO I. OLAYA JR. M.D. S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCO I OLAYA JR. M.D. (PRESIDENT)
(773) 581-8080
Entity
Organization
Contact information
Practice address
6222 S PULASKI RD, STE 2, CHICAGO, IL 60629-4610
(773) 581-8080
Mailing address
6222 S PULASKI RD, STE 2, CHICAGO, IL 60629-4610
(773) 581-8080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036048022
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021607326
BLUE CROSS/BLUE SHIELD
IL
05
—
036048022
—
IL
Enumeration date
07/23/2006
Last updated
03/07/2023
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