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Individual
LUIS JACINTO REDONDO
Active
Individual
LUIS JACINTO REDONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-075192
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036075192
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-075192
BLUE CROSS BLUE SHIELD PROVIDER NUMBER
IL
01
—
200034655
RAILROAD MEDICARE PROVIDER NUMBER
IL
Enumeration date
05/13/2006
Last updated
12/20/2021
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