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General NPI Number Information
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NPI Number | 1457528291
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Entity Type | Organization
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Legal Business Name | DR. JOSEPH'S MEDICAL SERVICES S.C.
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 5857 S ARCHER AVE UNIT B
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City | CHICAGO
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State | IL
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Zip | 60638-1619
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Country | US
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Telephone | 708-496-8400
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Fax | 708-496-8416
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Provider Business Mailing Address
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Address Line | 5857 S ARCHER AVE UNIT B
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City | CHICAGO
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State | IL
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Zip | 60638-1619
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Country | US
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Telephone | 708-496-8400
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Fax | 708-496-8416
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOZEF RZUCIDLO
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Credential | M.D.
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Telephone | 708-496-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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