Organization
MICHAEL DESTEFANO M.D. S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D. DESTEFANO M.D. (PRESIDENT)
(708) 214-9281
Entity
Organization
Contact information
Practice address
7000 W 111TH ST, WORTH, IL 60482-1851
(708) 214-9281
(708) 361-2742
Mailing address
12504 SOUTHWEST HWY, PALOS PARK, IL 60464-1851
(708) 214-9281
(708) 361-2742
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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