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Individual

DR. PANTALEO J AMOROSO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
675 W NORTH AVE, SUITE 609, MELROSE PARK, IL 60160-1634
(708) 450-5770
(708) 681-7675
Mailing address
675 W NORTH AVE, SUITE 609, MELROSE PARK, IL 60160-1634
(708) 450-5770
(708) 681-7675

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3647630
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21609229
BCBS IL PROVIDER NO.
IL
01
3647630
LICENSE NUMBER
IL
01
701258
UNITED HEALTHCARE
IL
Enumeration date
05/12/2006
Last updated
07/21/2022
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