Velasco, Jose M

Velasco, Jose M is an individual health care provider with primary practice located at 9669 Kenton Ave Suite #204, Skokie IL 60076-1266. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Velasco, Jose M can be contacted via phone (847) 982-1095.

Contact Information

Primary practice address
9669 Kenton Ave Suite #204 Skokie IL 60076-1266
Phone: (847) 982-1095
Fax: (847) 982-1098
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036055695 Illinois

Profile Details

NPI number 1386630366
LBN Legal business name Velasco, Jose M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Dec 31st, 2008 - about 18 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 1386630366 NPPES
Illinois MEDICAID 036055695

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