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Samuel J Traverso, DO
Student in an Organized Health Care Education/Training Program in La Grange, Illinois
NPI 1902464647

Samuel J Traverso is a Student in an Organized Health Care Education/Training Program based in La Grange, IL. Samuel J Traverso practices in La Grange, IL and has the professional credentials of DO. The NPI Number for Samuel J Traverso is 1902464647 and holds a License No. 125074102 (Illinois).

The current practice location address for Samuel J Traverso is 1325 Community Memorial Dr, La Grange, IL and can be reached out via phone at 708-245-8900 and via fax at 708-245-5721.

Location: 1325 Community Memorial Dr, La Grange, IL, 60525-2659
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902464647
Provider Name
Samuel J Traverso
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1325 Community Memorial Dr, La Grange, IL, 60525-2659
Phone Number
708-245-8900
Fax Number
708-245-5721
Provider Enumeration Date
05/29/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1325 Community Memorial Dr
City
La Grange
State
Illinois
Zip
60525-2659
Phone Number
708-245-8900
Fax Number
708-245-5721
person
Provider Business Mailing Address Details
Address
1325 Community Memorial Dr
City
La Grange
State
Illinois
Zip
60525-2659
Phone Number
708-245-8900
Fax Number
708-245-5721
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
125074102 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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