=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801052725
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOROTA MONIKA SZCZODRY M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2008
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4440 W 95TH ST ADVOCATE CHRIST MEDICAL CENTER, DEPT OF ANES
-----------------------------------------------------
City | OAK LAWN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60453-2600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-684-5053
-----------------------------------------------------
Fax | 708-684-4766
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4440 W 95TH ST ADVOCATE CHRIST MEDICAL CENTER, DEPT OF ANES
-----------------------------------------------------
City | OAK LAWN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60453-2600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-684-5053
-----------------------------------------------------
Fax | 708-684-4766
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 036126388
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------