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Individual

DR. DENNIS J. COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-2670
(217) 366-2669
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-2670
(217) 366-2669

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1724-850
WI
2086S0129X
Vascular Surgery Physician
Primary
036177187
IL
2086S0129X
Vascular Surgery Physician
49844
WI

Other

Enumeration date
06/22/2006
Last updated
02/17/2026
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