Deloso, David L

Deloso, David L is an individual health care provider with primary practice located at 2920 Veterans Memorial Dr , Mount Vernon IL 62864-5924. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Deloso, David L can be contacted via phone (618) 244-6544.

Contact Information

Primary practice address
2920 Veterans Memorial Dr Mount Vernon IL 62864-5924
Phone: (618) 244-6544
Fax: (618) 244-6577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036089974 Illinois

Profile Details

NPI number 1912002882
LBN Legal business name Deloso, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jun 7th, 2019 - about 5 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 1912002882 NPPES
Illinois MEDICAID 036089974
Illinois Other 4106916

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