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Individual

CORAZON B CUSTODIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
333 S. STATE STREET, REVENUE # 200 CHICAGO DEPTARTMENT OF PUBLIC HEALTH, CHICAGO, IL 60604
(312) 747-9443
(312) 747-9447
Mailing address
333 S. STATE STREET, REVENUE # 200 CHICAGO DEPTARTMENT OF PUBLIC HEALTH, CHICAGO, IL 60604
(312) 747-9443
(312) 747-9447

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IL

Other

Enumeration date
09/14/2006
Last updated
07/08/2007
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