Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036117515 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036117515 | IL |
NPI | 1831355585 |
---|---|
Provider Name | Dr. Gregory Paul Macaluso |
First Address | Palos Park, IL 60464-1508 |
Second Address | Palos Park, IL 60464-1508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01621708 | BCBS (01) | IL |
036117515 | (05) | IL |