Individual
STANISLAV I PAVLOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1401 W DUNDEE RD, SUITE 202, BUFFALO GROVE, IL 60089-4055
(847) 818-7700
(847) 818-1718
Mailing address
1401 W DUNDEE RD, SUITE 202, BUFFALO GROVE, IL 60089-4055
(847) 818-7700
(847) 818-1718
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036098316
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021623087
BCBS
IL
05
—
036098316
—
IL
Enumeration date
10/16/2006
Last updated
08/07/2009
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