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Organization
PODZAMSKY MEDICAL SERVICES
Active
Organization
PODZAMSKY MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E PODZAMSKY D.O. (PRESIDENT)
(309) 432-2441
Entity
Organization
Contact information
Practice address
301 S BLOOMINGTON ST, STREATOR, IL 61364-2969
(815) 673-2441
(815) 672-2178
Mailing address
120 E. 7TH ST., MINONK, IL 61760
(309) 432-2515
(309) 432-2160
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
036055223
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055223
—
IL
01
—
1225013840
NPI
IL
01
—
645950
PTAN - MINONK ILLINOIS LOCATION OF SERVICE
IL
01
—
645951
PTAN - STREATOR ILLINOIS LOCATION OF SERVICE
IL
Enumeration date
08/12/2009
Last updated
12/19/2012
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