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Organization
ANASTACIA R. LARGOSA MD
Active
Organization
ANASTACIA R. LARGOSA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANASTACIA R LARGOSA M.D. (PRESIDENT)
(708) 424-7705
Entity
Organization
Contact information
Practice address
10448 S PULASKI RD, OAK LAWN, IL 60453-4895
(708) 424-7705
(708) 424-0502
Mailing address
10448 S PULASKI RD, OAK LAWN, IL 60453-4895
(708) 424-7705
(708) 424-0502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036057514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057514
—
IL
Enumeration date
05/30/2007
Last updated
06/17/2008
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