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NPI Code Detail

MEDICARE: ANATOLIY PYSLAR

MEDICARE: ANATOLIY PYSLAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician036130419IL

General Provider Information

NPI Number : 1003146267
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANATOLIY PYSLAR
Provider Business Mailing Address
First Line : 9350 SKOKIE BLVD
Second Line : #308
City : SKOKIE
State : IL
Zip : 60077-1385
Country : US
Telephone Number : 216-255-4900
Fax Number :
Provider Business Practice Location Address
First Line : 3333 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-3095
Country : US
Telephone Number : 847-578-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2010
Last Update Date : 08/14/2012

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Directions to “ ANATOLIY PYSLAR ” Practice Location

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