Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | IL |
NPI | 1043300460 |
---|---|
Provider Name | Mr. Lorenzo Claude Aschinberg |
First Address | Joliet, IL 60435-6404 |
Second Address | Joliet, IL 60435-6404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 08/07/2007 |