Individual
DR. LUIS A COURET
Active
Individual
DR. LUIS A COURET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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