Organization
JOSE J VILLARREAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE J VILLARREAL MD (OFFICER)
(708) 774-2970
Entity
Organization
Contact information
Practice address
200 N HAMMES AVE, JOLIET, IL 60435-6677
(815) 744-6622
(815) 744-9585
Mailing address
PO BOX 967, TINLEY PARK, IL 60477-0967
(708) 532-6029
(708) 468-4991
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061053
—
IL
01
—
9900559
BCBS IL GR #
IL
Enumeration date
11/08/2005
Last updated
10/30/2018
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