Individual
GREGG S COCCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1423 CHICAGO RD, RADIOLOGY DEPARTMENT, CHICAGO HEIGHTS, IL 60411-3400
(708) 756-1000
Mailing address
1423 CHICAGO RD, RADIOLOGY DEPARTMENT, CHICAGO HEIGHTS, IL 60411-3400
(708) 756-1000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036085552
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085552
—
IL
01
—
078631
HEALTH ALLIANCE
—
01
—
131719100
DEPARTMENT OF LABOR
—
01
—
1618334
BCBS ID
IL
01
—
300050047
RAILROAD ID
—
01
—
L022428
CHAMPUS
—
Enumeration date
09/13/2006
Last updated
05/26/2015
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