Provider Demographics
NPI:1962778092
Name:OSCAR S. GIRON, M.D., S.C.
Entity type:Organization
Organization Name:OSCAR S. GIRON, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-548-2000
Mailing Address - Street 1:1828 E BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2289
Mailing Address - Country:US
Mailing Address - Phone:847-548-2000
Mailing Address - Fax:847-548-2065
Practice Address - Street 1:1828 E BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2289
Practice Address - Country:US
Practice Address - Phone:847-548-2000
Practice Address - Fax:847-548-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036044235170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036044235OtherILINOIS DEPT. OF PUBLIC AIDE
IL313921Medicaid
ILL003547OtherTRI CARE (CHAMPUS)
IL05700469OtherHEALTH CONNECT
IL004900542OtherBCBS
IL1841331014OtherINDIVIDUAL NPI
ILL003547OtherTRI CARE (CHAMPUS)