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General NPI Number Information
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NPI Number | 1710131503
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Entity Type | Organization
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Legal Business Name | PLONSKI MEDICAL S.C.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 6901 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2319
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Country | US
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Telephone | 773-229-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 6901 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2319
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Country | US
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Telephone | 773-229-8300
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DONNA PLONSKI
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Credential |
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Telephone | 773-229-8300
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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 | 036-066226
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License Number State | IL
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