Organization
ENDOCRINE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREE C DE BUSTROS M.D. (M.D./SOLE PROPRIETOR)
(708) 532-6490
Entity
Organization
Contact information
Practice address
6703 159TH ST, SUITE 107, TINLEY PARK, IL 60477-1781
(708) 532-6490
(708) 532-6262
Mailing address
PO BOX 1090, MATTESON, IL 60443-4090
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-081805
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001636300
BCBSIL GROUP #
IL
Enumeration date
05/19/2006
Last updated
12/03/2009
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