Healthcare Provider Details

I. General information

NPI: 1801001847
Provider Name (Legal Business Name): PLONSKI & RZUCIDLO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 W ARCHER AVE
CHICAGO IL
60638-2319
US

IV. Provider business mailing address

6901 W ARCHER AVE
CHICAGO IL
60638-2319
US

V. Phone/Fax

Practice location:
  • Phone: 773-229-8300
  • Fax: 773-229-8326
Mailing address:
  • Phone: 773-229-8300
  • Fax: 773-229-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. BARBARA RZUCIDLO
Title or Position: OFFICE MANAGER
Credential:
Phone: 773-229-8300