Provider Demographics
NPI:1457403784
Name:ORIG, CARLITO VILLABONA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLITO
Middle Name:VILLABONA
Last Name:ORIG
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3900 YORK ROAD
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:708-496-1515
Mailing Address - Fax:708-496-1788
Practice Address - Street 1:6500 N 65TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638
Practice Address - Country:US
Practice Address - Phone:708-496-1515
Practice Address - Fax:708-496-1788
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD128752083X0100X
IL2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine