A Podolskiy Md Sc

LBN: A Podolskiy Md Sc
A Podolskiy Md Sc is an health care organization with primary practice located at 755 S Milwaukee Ave Suite 164, Libertyville IL 60048-3253. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. A Podolskiy Md Sc can be contacted via phone (847) 918-0430, or through Podolskiy, Aleksandr via phone (847) 918-0430.

Contact Information

Primary practice address
755 S Milwaukee Ave Suite 164 Libertyville IL 60048-3253
Phone: (847) 918-0430
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Podolskiy, Aleksandr Doctor of Medicine (MD)
Phone: (847) 918-0430

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036111753 Illinois

Profile Details

NPI number 1578634168
LBN Legal business name A Podolskiy Md Sc
DBA Doing business as
Authorized official Podolskiy, Aleksandr Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2006
Last updated May 14th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578634168 NPPES
Illinois MEDICAID 036111753

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