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Individual

JOSEPH M. PAVESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4225 W 95TH ST, OAK LAWN, IL 60453-2623
(708) 423-2300
(708) 423-2318
Mailing address
4225 W 95TH ST, OAK LAWN, IL 60453-2623
(708) 423-2300
(708) 423-2318

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036062600
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036062600
IL
01
0479220001
DMERC
IL
Enumeration date
10/23/2006
Last updated
06/17/2008
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