Petronilo R Costa, MD is a
Preventive Medicine - Undersea And Hyperbaric Medicine physician based in Deerfield, Illinois. Petronilo R Costa is licensed to practice in Illinois (license number 036-046-108) and his current practice location is 420 Lake Cook Rd Ste 118, Deerfield, Illinois. He can be reached at his office (for appointments etc.) via phone at
(847) 205-0237.
NPI number for Petronilo R Costa is 1043435340 and his current mailing address is 420 Lake Cook Rd Ste 118, Deerfield, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1043435340.
Physician's Profile
| Full Name | Petronilo R Costa |
|---|
| Gender | Male |
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| Speciality | Preventive Medicine - Undersea And Hyperbaric Medicine |
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| Location | 420 Lake Cook Rd Ste 118, Deerfield, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1043435340
- Provider Enumeration Date: 04/13/2007
- Last Update Date: 10/12/2016
Medical Identifiers
Medical identifiers for Petronilo R Costa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043435340 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | 036-046-108 (Illinois) | Primary |
| 208000000X | Pediatrics | 036-046-108 (Illinois) | Secondary |
| 2080A0000X | Pediatrics - Adolescent Medicine | 036-046-108 (Illinois) | Secondary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | 036-046-108 (Illinois) | Secondary |
| 2080P0008X | Pediatrics - Neurodevelopmental Disabilities | 036-046-108 (Illinois) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036-046-108 (Illinois) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 036-046-108 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Petronilo R Costa is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Petronilo R Costa, MD
420 Lake Cook Rd Ste 118,
Deerfield, IL 60015-4914
Ph: (847) 205-0237 | Petronilo R Costa, MD
420 Lake Cook Rd Ste 118,
Deerfield, IL 60015-4914
Ph: (847) 205-0237 |
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