Individual
FERNANDO A AMPUERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3517 W 26TH ST, CHICAGO, IL 60623-3910
(773) 521-6001
(773) 521-1154
Mailing address
PO BOX 6811, CHICAGO, IL 60680-6811
(773) 521-6001
(773) 521-1154
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036066158
IL
Other
Enumeration date
05/25/2006
Last updated
10/24/2014
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