Provider Demographics
NPI:1912099201
Name:VILLARUZ, ALCHRISTIAN COSCA (MD)
Entity type:Individual
Prefix:DR
First Name:ALCHRISTIAN
Middle Name:COSCA
Last Name:VILLARUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 WEST MORSE
Mailing Address - Street 2:UNIT 3 SOUTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626
Mailing Address - Country:US
Mailing Address - Phone:773-761-0545
Mailing Address - Fax:
Practice Address - Street 1:3001 NORTH GREEN BAY ROAD
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:224-610-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD48324207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine