Provider Demographics
NPI:1184863672
Name:ESPOSITO, IRMA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 N SHERIDAN RD STE 434
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5078
Mailing Address - Country:US
Mailing Address - Phone:773-751-4106
Mailing Address - Fax:
Practice Address - Street 1:2200 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-3412
Practice Address - Country:US
Practice Address - Phone:773-751-1875
Practice Address - Fax:773-338-4049
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine