Basic Information
| Provider Information | |||||||||
| NPI: | 1689776593 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUINTO | ||||||||
| FirstName: | MERT | ||||||||
| MiddleName: | VERZO | ||||||||
| NamePrefix: | DR. | ||||||||
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| OtherLastName: | GUINTO | ||||||||
| OtherFirstName: | MAMERTO | ||||||||
| OtherMiddleName: | VERZO | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2905 WHITETAIL DR | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619203866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173454503 | ||||||||
| FaxNumber: | 2173454503 | ||||||||
| Practice Location | |||||||||
| Address1: | 721 E COURT ST | ||||||||
| Address2: | |||||||||
| City: | PARIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619442460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2174654141 | ||||||||
| FaxNumber: | 2174632769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 02/22/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036-053711 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208D00000X | 036-053711 | IL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.