Individual
JOSEPH L GIACCHINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1252 WINSTON PLAZA, MELROSE PARK, IL 60160
(708) 343-2500
(708) 343-9545
Mailing address
1252 WINSTON PLAZA, MELROSE PARK, IL 60160
(708) 343-2500
(708) 343-9545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036050366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050366
—
IL
01
—
16172816
BLUE CROSS BLUE SHIELD
IL
01
—
738410
MEDICARE
IL
Enumeration date
12/27/2006
Last updated
06/02/2008
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