Provider Demographics
NPI:1689869455
Name:OFELIA B. AYUSTE M.D.S.C.
Entity Type:Organization
Organization Name:OFELIA B. AYUSTE M.D.S.C.
Other - Org Name:AYUSTE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OFELIA
Authorized Official - Middle Name:BARRIOS
Authorized Official - Last Name:AYUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-971-8881
Mailing Address - Street 1:4121 FAIRVIEW AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2266
Mailing Address - Country:US
Mailing Address - Phone:630-971-8881
Mailing Address - Fax:630-971-8842
Practice Address - Street 1:4121 FAIRVIEW AVE STE 100
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2266
Practice Address - Country:US
Practice Address - Phone:630-971-8881
Practice Address - Fax:630-971-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty