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General NPI Number Information
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NPI Number | 1356618037
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Entity Type | Organization
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Legal Business Name | MARIA BAGINSKI M.D. LTD
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 3929 N CENTRAL AVE STE 4
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City | CHICAGO
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State | IL
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Zip | 60634-3072
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Country | US
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Telephone | 773-685-8622
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Fax | 773-685-8980
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Provider Business Mailing Address
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Address Line | 3929 N CENTRAL AVE STE 4
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City | CHICAGO
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State | IL
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Zip | 60634-3072
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Country | US
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Telephone | 773-685-8622
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Fax | 773-685-8980
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARIA JANINA BAGINSKI
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Credential | M.D.
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Telephone | 773-685-8622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036086530
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License Number State | IL
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