Individual
JOSE DUTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 N SAINT CLAIR ST, GALTER 15-200, CHICAGO, IL 60611-5975
(312) 695-8182
(312) 695-7851
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
(312) 695-8182
(312) 695-7851
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036102537
IL
Other
Enumeration date
06/23/2006
Last updated
06/30/2009
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