Dipasquo, Raymond P

Dipasquo, Raymond P is an individual health care provider with primary practice located at 12701 W 143Rd St Suite 250, Homer Glen IL 60491-7715. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dipasquo, Raymond P can be contacted via phone (708) 301-1400.

Contact Information

Primary practice address
12701 W 143Rd St Suite 250 Homer Glen IL 60491-7715
Phone: (708) 301-1400
Fax: (708) 301-4295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036069676 Illinois

Profile Details

NPI number 1912950916
LBN Legal business name Dipasquo, Raymond P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated May 18th, 2012 - about 12 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 1912950916 NPPES
Illinois MEDICAID 036069676

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