Individual
DR. AGUSTIN DEQUINA DORMITORIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 271-9040
Mailing address
1109 HYDE PARK LN, NAPERVILLE, IL 60565-1622
(773) 578-1464
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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