Dastice, Michael D

Dastice, Michael D is an individual health care provider with primary practice located at 10500 S Cicero Ave , Oak Lawn IL 60453-5205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Dastice, Michael D can be contacted via phone (708) 424-1202.

Contact Information

Primary practice address
10500 S Cicero Ave Oak Lawn IL 60453-5205
Fax: (708) 424-1395
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 036086042 Illinois

Profile Details

NPI number 1952358939
LBN Legal business name Dastice, Michael D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated May 2nd, 2024 - about 6 months 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 1952358939 NPPES
Illinois MEDICAID 036086042

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