Individual
MS. GLORIA BUENTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 W LAKE ST., SUITE 409, MELROSE PARK, IL 60160
(708) 499-7510
(708) 345-0332
Mailing address
PO BOX 5488, RIVER FOREST, IL 60305
(708) 499-7510
(708) 345-0332
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
01042635B
IN
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
IL
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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