Individual
DR. RADOMIR PIWKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Mailing address
5200 COMMERCE CROSSING, 3RD FLOOR, LOUISVILLE, KY 40229
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125056990
IL
208M00000X
Hospitalist Physician
Primary
01071086A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000773791
ANTHEM PROVIDER NUMBER
IN
05
—
201074520
—
IN
Enumeration date
06/26/2009
Last updated
12/07/2020
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