Healthcare Provider Details

I. General information

NPI: 1033164025
Provider Name (Legal Business Name): AD MEDICAL LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6422 W. BELMONT AVE
CHICAGO IL
60634-3921
US

IV. Provider business mailing address

6422 W. BELMONT AVE
CHICAGO IL
60634-3921
US

V. Phone/Fax

Practice location:
  • Phone: 773-481-2504
  • Fax: 773-481-2516
Mailing address:
  • Phone: 773-481-2504
  • Fax: 773-481-2516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number036-077694
License Number StateIL

VIII. Authorized Official

Name: ALEKSY DOBRADIN
Title or Position: CEO/ PRESIDENT
Credential: MD
Phone: 773-481-2509