Organization
LUIS A OSORIO M.D.S.C.
Active
Other names
Family Medical Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS ANTONIO OSORIO JR. M.D. (OWNER)
(708) 749-0277
Entity
Organization
Contact information
Practice address
6721 CERMAK RD, BERWYN, IL 60402-2216
(708) 749-0277
Mailing address
6721 CERMAK RD, BERWYN, IL 60402-2216
(708) 749-0277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.087612
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087612
—
IL
Enumeration date
03/07/2012
Last updated
03/07/2012
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