Individual
DR. JOSE LUIS RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1124 ESSINGTON RD, JOLIET, IL 60435-8423
(815) 744-8554
(815) 744-3969
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(708) 634-4602
(630) 495-1770
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036-109103
IL
208200000X
Plastic Surgery Physician
2020-00458
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109103
—
IL
01
—
09932211
BC/BS PPO PROVIDER NUMBER
IL
Enumeration date
08/16/2006
Last updated
06/24/2020
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