Individual
DR. IRWIN DOUGLAS OBISPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 W 95TH ST, EVERGREEN PARK, IL 60805-2807
(708) 229-0892
(708) 229-0914
Mailing address
2500 W 95TH ST, EVERGREEN PARK, IL 60805-2807
(708) 229-0892
(708) 229-0914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051297247
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71-0415188
—
IL
Enumeration date
08/27/2019
Last updated
08/27/2019
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