Radzienda, Michael Louis

Radzienda, Michael Louis is an individual health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Radzienda, Michael Louis can be contacted via phone (708) 216-9000.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (708) 216-9000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01060676A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 50075 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036095779 Illinois

Profile Details

NPI number 1457342610
LBN Legal business name Radzienda, Michael Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Apr 28th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457342610 NPPES
Wisconsin MEDICAID 34752800

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