Individual
DR. CONCEPTA LASQUITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1817 S LOOMIS ST, CHICAGO, IL 60608-3018
(312) 666-6511
(312) 666-1658
Mailing address
1817 S LOOMIS ST, CHICAGO, IL 60608-3018
(312) 666-6511
(312) 666-1658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036083208
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360832081
—
IL
Enumeration date
01/29/2007
Last updated
05/13/2012
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