Individual
DR. F. WILFORD GERMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16660 S. 107TH AVE., ORLAND PARK, IL 60467
(708) 403-8500
(708) 364-7080
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036062103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630151
BCBS PROVIDER GROUP #
IL
05
—
036062103
—
IL
01
—
14D0991123
CLIA #
IL
01
—
4082441
AETNA PROVIDER ID#
IL
01
—
705600
MEDICARE GROUP #
IL
Enumeration date
07/27/2006
Last updated
04/13/2021
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