Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | IL | |
Y | 213ER0200X | Radiology | IL |
NPI | 1700080926 |
---|---|
Provider Name | Dr. Vincent Frank Debono |
First Address | Lombard, IL 60148-4539 |
Second Address | Lombard, IL 60148-4539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 08/07/2007 |