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Individual

DR. TERESITA AVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3825 HIGHLAND AVE, STE 2F, DOWNERS GROVE, IL 60515-1548
(630) 852-3762
(630) 829-6818
Mailing address
3825 HIGHLAND AVE, STE 2F, DOWNERS GROVE, IL 60515-1548
(630) 852-3762
(630) 829-6818

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036045193
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036045193
IL
Enumeration date
06/16/2005
Last updated
01/31/2013
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