Civantos, Joseph M
Civantos, Joseph M is an individual health care provider with primary practice located at 71 W 156Th St Suite 400, Harvey IL 60426-4265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Civantos, Joseph M can be contacted via phone (708) 596-8710.Contact Information
Primary practice address
71 W 156Th St Suite 400
Harvey IL 60426-4265
Phone: (708) 596-8710
Fax: (708) 596-9820
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036086038 | Illinois |
Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 036086038 | Illinois |
Profile Details
NPI number | 1336149053 |
---|---|
LBN Legal business name | Civantos, Joseph M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 22nd, 2005 |
Last updated | Feb 4th, 2022 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1336149053 | NPPES |
Illinois | MEDICAID | 036086038 | |
Illinois | Other | 180030696 | |
Illinois | Other | 180015438 |
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