Organization
OSCAR L ALONSO MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR L ALONSO MD (OWNER)
(630) 960-5310
Entity
Organization
Contact information
Practice address
1034 WARREN AVE, DOWNERS GROVE, IL 60515-3601
(630) 960-5310
(630) 969-7841
Mailing address
1121 WARREN AVE STE 200, DOWNERS GROVE, IL 60515-3572
(630) 960-5310
(630) 969-7841
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036064967
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31602726
BLUE SHIELD
IL
05
—
762140
—
IL
Enumeration date
06/17/2008
Last updated
12/22/2020
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