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Individual

PAWEL S DUDEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4250 N MARINE DR, SUITE 236, CHICAGO, IL 60613-1744
(773) 404-0160
(773) 404-9876
Mailing address
4840 N MARINE DR, CHICAGO, IL 60640-7860
(773) 654-1645
(773) 681-9876

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036096327
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01635497
BLUE CROSS BLUE SHIELD IL
IL
05
036096327
IL
01
180759
COMPSYCH
IL
01
2017926
CIGNA
IL
01
401806
HARMONY
IL
01
404206
VALUE OPTIONS
IL
01
415428
MHN
IL
Enumeration date
04/01/2006
Last updated
06/24/2010
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