Organization
SOUTHWEST RHEUMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL DELBUSTO M.D (DOCTOR)
(708) 423-1130
Entity
Organization
Contact information
Practice address
2850 W 95TH ST, SUITE 200, EVERGREEN PARK, IL 60805-2735
(708) 423-1130
(708) 423-3610
Mailing address
2850 W 95TH ST, SUITE 200, EVERGREEN PARK, IL 60805-2735
(708) 423-1130
(708) 423-3610
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036083298
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632140
BCBS OF IL
IL
01
—
CJ6175
RR MEDICARE
IL
Enumeration date
04/04/2007
Last updated
08/30/2010
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