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Individual

LAURO AMEZCUA-PATINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
4055 W CHANDLER BLVD, SUITE #5, CHANDLER, AZ 85226-3700
(480) 464-4431
(480) 464-2338

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036168702
IL
2084P0800X
Psychiatry Physician
17900
AZ
2084P0800X
Psychiatry Physician
4023
WI
2084P0800X
Psychiatry Physician
C1-0026764
DE
2084P0800X
Psychiatry Physician
MD61530096
WA
2084P0800X
Psychiatry Physician
T6429
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17900
MEDICAL LICENSE
AZ
01
T6429
TEXAS MEDICAL BOARD
TX
Enumeration date
08/29/2005
Last updated
06/03/2025
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