Individual
BOHDAN FEDIRKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5255 S CICERO AVE, CHICAGO, IL 60632-4915
(773) 585-7505
(773) 585-7507
Mailing address
PO BOX 388309, CHICAGO, IL 60638-8309
(773) 585-7505
(773) 585-7507
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
036098499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098499
—
IL
Enumeration date
05/20/2006
Last updated
12/20/2016
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