Bodnar, Yaroslav Daniel
Bodnar, Yaroslav Daniel is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bodnar, Yaroslav Daniel can be contacted via phone (309) 655-3863.Contact Information
Primary practice address
530 Ne Glen Oak Ave
Peoria IL 61637-0001
Phone: (309) 655-3863
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125.070456 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 125.070456 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036155975 | Illinois |
Profile Details
| NPI number | 1801326095 |
|---|---|
| LBN Legal business name | Bodnar, Yaroslav Daniel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 19th, 2017 |
| Last updated | May 19th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801326095 | NPPES |
| Illinois | Other | 125.070456 | TEMPORARY MEDICAL LICENSE |
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