LICUDINE & LICUDINE MD SC
Radiology at Washington Blvd, Chicago, IL

License number
Illinois 036051696
Category
Osteopathic Medicine
Type
Family Medicine
License number
Illinois 036046217
Category
Radiology
Type
Surgery
Owner
Name: DR. NORMITA M LICUDINE MD
Title: SECRETARY
Phone: (773) 379-4348
Address
Address
4758 W Washington Blvd, Chicago, IL 60644
National Provider ID: 1538245832
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LICUDINE & LICUDINE, M.D., S.C

Lincolnwood, IL 60712

Registration:
Feb 23, 1978
State ID:
51378679
Business type:
Domestic Bca
Expiration:
Perpetual
Agent:
Ron Navarro,4508 W Irving Park Rd, Chicago, IL 60641 (Physical)

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