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NPI Code Detail

MEDICARE: DR. MARINA SHVARTSMAN M.D.

MEDICARE: DR. MARINA SHVARTSMAN M.D.
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1417121005
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARINA SHVARTSMAN M.D.
Provider Business Mailing Address
First Line : 6420 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60645-5253
Country : US
Telephone Number : 773-973-6100
Fax Number : 773-262-4882
Provider Business Practice Location Address
First Line : 6420 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60645-5253
Country : US
Telephone Number : 773-973-6100
Fax Number : 773-262-4882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 04/15/2008

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