Provider Demographics
NPI:1285693127
Name:MOTTO, GEORGE SALVATORE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SALVATORE
Last Name:MOTTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:637 S BRISTOL LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2709
Mailing Address - Country:US
Mailing Address - Phone:847-758-0886
Mailing Address - Fax:847-394-9255
Practice Address - Street 1:637 S BRISTOL LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2709
Practice Address - Country:US
Practice Address - Phone:847-394-0846
Practice Address - Fax:847-394-9255
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-041211207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43752Medicare UPIN