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NPI Code Detail

MEDICARE: OLEH PALY M.D.

MEDICARE:   OLEH  PALY  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
1208100000XPhysical Medicine & Rehabilitation Physician036072020IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104905190OTHERILBLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477574374
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLEH PALY M.D.
Provider Business Mailing Address
First Line : PO BOX 388320
Second Line :
City : CHICAGO
State : IL
Zip : 60638-8320
Country : US
Telephone Number : 773-767-4600
Fax Number : 773-767-8320
Provider Business Practice Location Address
First Line : 34905 N LAKE MATTHEWS TRL
Second Line :
City : INGLESIDE
State : IL
Zip : 60041-9480
Country : US
Telephone Number : 773-767-8283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 08/26/2009

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