Individual
DAVID L DELOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2920 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-5924
(618) 244-6544
(618) 244-6577
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-1624
(618) 724-4628
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036089974
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089974
—
IL
01
—
4106916
BCBS
—
Enumeration date
09/14/2006
Last updated
06/07/2019
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