Organization
STARSURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE ESPINO RCSA (PHYSICIAN)
(630) 330-1761
Entity
Organization
Contact information
Practice address
2373 WHITE ROSE DR, MONTGOMERY, IL 60538-5140
(630) 330-1761
(630) 762-9681
Mailing address
PO BOX 88543, CAROL STREAM, IL 60188-0543
(630) 330-1761
(630) 762-9681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
238.000022
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04732058
BC PROVIDER NUMBER
IL
01
—
1407882210
NPI FOR PROVIDER JOSE ESPINO
IL
01
—
1891095196
NPI FOR MARIA KONIECZKO
IL
Enumeration date
05/30/2008
Last updated
04/28/2011
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