Individual
LUCIANO FOCHESATTO FILHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13755 CICERO AVE, CRESTWOOD, IL 60418
(708) 385-2400
(708) 385-8130
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 654-4253
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036124456
IL
208M00000X
Hospitalist Physician
036124456
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124456
—
IL
05
—
201034520
—
IN
Enumeration date
09/24/2008
Last updated
05/10/2023
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