Individual
PAUL CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-2387
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01061485A
IN
2086S0129X
Vascular Surgery Physician
Primary
036133177
IL
Other
Enumeration date
10/11/2007
Last updated
05/18/2022
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