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General NPI Number Information
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NPI Number | 1144400474
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Entity Type | Organization
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Legal Business Name | OLIVER DRABKIN M.D. S.C.
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Dates
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Enumeration Date | 11/03/2007
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Last Update Date | 11/03/2007
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Provider Practice Location Address
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Address Line | 3900 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-1922
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Country | US
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Telephone | 708-423-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-1922
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Country | US
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Telephone | 708-423-7550
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OLIVER DRABKIN
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Credential | M.D.
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Telephone | 708-423-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 03642295
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License Number State | IL
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