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Individual

ENRIQUE CORNEJO CISNEROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
441 E ERIE ST APT 3205, CHICAGO, IL 60611-4429
(314) 560-2165
Mailing address
441 E ERIE ST APT 3205, CHICAGO, IL 60611-4429
(314) 560-2165

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011015465
MO
207RI0200X
Infectious Disease Physician
Primary
125.064371
IL

Other

Enumeration date
07/07/2011
Last updated
07/21/2022
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