Organization
PILSEN COMMUNITY PEDIATRICS S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO E OROZA-HENNERS M.D. (PRESIDENT)
(312) 666-5455
Entity
Organization
Contact information
Practice address
1859 S BLUE ISLAND AVE, CHICAGO, IL 60608-3012
(312) 666-5455
Mailing address
1859 S BLUE ISLAND AVE, CHICAGO, IL 60608-3012
(312) 666-5455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/03/2006
Last updated
03/09/2012
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