Individual
DR. LUIS A COURET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2930 MANNHEIM RD, SUITE #1, FRANKLIN PARK, IL 60131-2265
(847) 451-4064
(847) 451-4098
Mailing address
2930 MANNHEIM RD, SUITE #1, FRANKLIN PARK, IL 60131-2265
(847) 451-4064
(847) 451-4098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036090038
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632309
BCBS OF IL PROVIDER
IL
05
—
036090038
—
IL
01
—
043632612
TAX ID
—
01
—
110235189
RR MEDICARE PROVIDER #
—
01
—
14D1010159
IL CLIA #
IL
Enumeration date
10/12/2006
Last updated
01/03/2008
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