Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036.154932 | IL |
NPI | 1013413392 |
---|---|
Provider Name | Piotr Wlodkowski |
First Address | Park Ridge, IL 60068-1005 |
Second Address | Park Ridge, IL 60068-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 24/01/2022 |