Individual provider · NPI-1

Fernando A Ampuero, MD

Obstetrics & Gynecology, Gynecology · Chicago, IL

NPI number1760438477
StatusActive
Last updated in NPPESOct 24, 2014

Details

NPI
1760438477
Entity type
Individual (NPI-1)
Name
Fernando A Ampuero
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
May 25, 2006
Last updated
Oct 24, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207VG0400X Obstetrics & Gynecology, Gynecology036066158ILYes

Practice location

3517 W 26th St
Chicago, IL 60623-3910

Phone 773-521-6001 · Fax 773-521-1154

Mailing address

Po Box 6811
Chicago, IL 60680-6811

Phone 773-521-6001 · Fax 773-521-1154

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