Avila, Teresita

Avila, Teresita is an individual health care provider with primary practice located at 3825 Highland Ave Ste 2F, Downers Grove IL 60515-1548. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Avila, Teresita can be contacted via phone (630) 852-3762.

Contact Information

Primary practice address
3825 Highland Ave Ste 2F Downers Grove IL 60515-1548
Phone: (630) 852-3762
Fax: (630) 829-6818
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036045193 Illinois

Profile Details

NPI number 1386649317
LBN Legal business name Avila, Teresita
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jan 31st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386649317 NPPES
Illinois MEDICAID 036045193

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