Individual
GUSTAVO E OROZA-HENNERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1859 S BLUE ISLAND AVE, CHICAGO, IL 60608-3012
(312) 666-5455
Mailing address
1205 N MARION ST, OAK PARK, IL 60302-1253
(312) 666-5455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-083375
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083375
—
IL
Enumeration date
11/07/2006
Last updated
07/08/2007
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