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General NPI Number Information
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NPI Number | 1396007456
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Entity Type | Organization
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Legal Business Name | EUGENIA GROCHOWSKA MD
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 5647 W LAWRENCE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3219
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Country | US
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Telephone | 773-545-5252
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Fax | 773-545-5671
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Provider Business Mailing Address
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Address Line | 5647 W LAWRENCE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3219
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Country | US
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Telephone | 773-545-5252
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Fax | 773-545-5671
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Authorized Official
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Title or Position | OWNER
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Name | EUGENIA GROCHOWSKA
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Credential | M.D.
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Telephone | 773-545-5252
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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 |
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License Number State |
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