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Organization
MARINA KUZNETSOVA MD SC
Active
Organization
MARINA KUZNETSOVA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA KUZNETSOVA M.D. (PRESIDENT)
(773) 564-5070
Entity
Organization
Contact information
Practice address
4646 N MARINE DR, RADIATION ONCOLOGY DEPARTMENT, CHICAGO, IL 60640-5759
(773) 564-5070
(773) 564-5071
Mailing address
4646 N MARINE DR, RADIATION ONCOLOGY DEPARTMENT, CHICAGO, IL 60640-5759
(773) 564-5070
(773) 564-5071
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632270
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
08/16/2006
Last updated
10/29/2007
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