Individual
DR. JULIO DIOSMAN PERNIA-CUBEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3059 W 26TH ST, CHICAGO, IL 60623-4131
(773) 584-6200
(844) 285-1003
Mailing address
2001 S CALIFORNIA AVE STE 100, CHICAGO, IL 60608-2486
(773) 584-6200
(844) 285-1003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036156493
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036156493
—
IL
Enumeration date
06/22/2018
Last updated
06/29/2021
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