Individual
DR. ANASTACIA R LARGOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10448 S PULASKI RD, OAK LAWN, IL 60453-4895
(708) 424-7705
(708) 424-0502
Mailing address
10448 S PULASKI RD, OAK LAWN, IL 60453-4895
(708) 424-7705
(708) 424-0502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036057514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057514
—
IL
Enumeration date
06/02/2006
Last updated
01/03/2014
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