Provider Demographics
NPI:1144233263
Name:CUNILL, DENISE RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RENEE
Last Name:CUNILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2840 W FULLERTON AVE
Mailing Address - Street 2:LOGAN SQUARE HEALTH CENTER OF COOK COUNTY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2938
Mailing Address - Country:US
Mailing Address - Phone:773-395-2966
Mailing Address - Fax:773-395-9608
Practice Address - Street 1:2840 W FULLERTON AVE
Practice Address - Street 2:LOGAN SQUARE HEALTH CENTER OF COOK COUNTY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2938
Practice Address - Country:US
Practice Address - Phone:773-395-2966
Practice Address - Fax:773-395-9608
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-105752208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH76807Medicare UPIN