Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 036-108495 | IL |
NPI | 1063539211 |
---|---|
Provider Name | Alfred S Guirguis |
First Address | Oak Lawn, IL 60453-2199 |
Second Address | Oak Lawn, IL 60453-2199 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 25/08/2020 |