Provider Demographics
NPI:1578521902
Name:PALUTSIS, PHILIP STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:STANLEY
Last Name:PALUTSIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:4413 ROOSEVELT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2074
Practice Address - Country:US
Practice Address - Phone:708-449-0741
Practice Address - Fax:708-449-0994
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-03-02
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Provider Licenses
StateLicense IDTaxonomies
IL036062738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036062738Medicaid
IL036062738Medicaid