Individual
TOMAS MAURICIO PRUDENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-2000
Mailing address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.085227
IL
Other
Enumeration date
03/24/2025
Last updated
06/16/2025
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