Michael Destefano M.d. S.c.

NPI #1801082870 in Worth, Illinois

Provider Information

NPI Number: 1801082870
Entity Type: Organization
Organization Name: Michael Destefano M.d. S.c.
Primary Specialty: Pediatrics
Enumeration Date: Sep 24, 2007
Last Updated: Sep 24, 2007

Practice Location

Address: 7000 W 111TH ST
City: Worth
State: Illinois
ZIP Code: 60482-1851
Phone: (708) 214-9281

Authorized Official

Name: MICHAEL D. DESTEFANO, M.D.
Title: PRESIDENT
Phone: (708) 214-9281

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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