Mark Ettore Giacomi JR. D.O

NPI 1639334667 - Family Medicine - 207Q00000X

NPI Details
NPI 1639334667
Gender Male
Enumeration Date 07/18/2008
Last Updated 12/19/2014
Entity Type Individual
Active Over 8 years ago
Practice Location
23836 W 135TH ST
STE 103
PLAINFIELD IL, 60544-5620, US
Phone (815) 254-2403
Fax (815) 267-8380
Business Location
23836 W 135TH ST
STE 103
PLAINFIELD IL, 60544-5620, US
Phone (815) 254-2403
Fax (815) 267-8380
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number 036126516
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According to our database, Mark Ettore Giacomi JR. D.O NPI is 1639334667, taxonomy code is 207Q00000X and license number is 036126516, license state is located at Illinois. Mark Ettore Giacomi JR. D.O physically located at 23836 W 135th St, Plainfield IL, 60544-5620. NPI Number Mark Ettore Giacomi JR. D.O has the Individual type.

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1639334667 NPI number is provided on an as is basis without warranty of any kind. 1639334667 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Ettore Giacomi JR. D.O are for informational purposes only.