Provider Demographics
NPI:1568764777
Name:LUIS GONZALEZ-OROZCO MD SC
Entity Type:Organization
Organization Name:LUIS GONZALEZ-OROZCO MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-297-1515
Mailing Address - Street 1:494 LEE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4607
Mailing Address - Country:US
Mailing Address - Phone:847-297-1515
Mailing Address - Fax:847-297-3390
Practice Address - Street 1:494 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4607
Practice Address - Country:US
Practice Address - Phone:847-297-1515
Practice Address - Fax:847-297-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-055907261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care