Basic Information
| Provider Information | |||||||||
| NPI: | 1689649105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOSCOSO | ||||||||
| FirstName: | SYLVIA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2014 MIDWEST CLUB PKWY | ||||||||
| Address2: | |||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605232526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306551014 | ||||||||
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| Practice Location | |||||||||
| Address1: | 966 W 21ST ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606084511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732541400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2006 | ||||||||
| LastUpdateDate: | 07/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 036-103740 | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207Q00000X | 036-103740 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.