Provider Demographics
NPI:1477607422
Name:PURAY, CESAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:M
Last Name:PURAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 DIXIE HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1989
Mailing Address - Country:US
Mailing Address - Phone:708-799-0990
Mailing Address - Fax:708-799-0991
Practice Address - Street 1:1835 DIXIE HWY STE 104
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1989
Practice Address - Country:US
Practice Address - Phone:708-799-0990
Practice Address - Fax:708-799-0991
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-052610208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13188Medicare UPIN
IL036052610Medicare ID - Type Unspecified
IL494710Medicare PIN