Provider Demographics
NPI:1790712347
Name:ADAMO, GREGORY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:P
Last Name:ADAMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8420 W 119TH PL
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-3104
Mailing Address - Country:US
Mailing Address - Phone:708-528-2326
Mailing Address - Fax:
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3311
Practice Address - Country:US
Practice Address - Phone:847-437-5500
Practice Address - Fax:847-952-7912
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-0539122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC37983Medicare UPIN