Individual
NICHOLAS P GUISTO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18221 TORRENCE AVE, LANSING, IL 60438-2870
(630) 886-3026
Mailing address
18221 TORRENCE AVE, LANSING, IL 60438-2870
(630) 886-3026
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036111870
IL
208VP0014X
Interventional Pain Medicine Physician
036111870
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111870
—
IL
Enumeration date
08/09/2006
Last updated
04/18/2012
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