Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | IL |
NPI | 1275758955 |
---|---|
Provider Name | Dr. Lourdes D Floro |
First Address | Oak Lawn, IL 60453-3789 |
Second Address | Oak Lawn, IL 60453-3789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21603560 | BCBS (01) | IL |
D93826 | (02) | IL |