Organization
HARVEY DEBOFSKY MD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNETTE MCROY (BILLING COORDINATOR)
(773) 767-3822
Entity
Organization
Contact information
Practice address
2315 E 93RD ST, SUITE 200, CHICAGO, IL 60617-3936
(773) 734-3970
(773) 734-6832
Mailing address
2315 E 93RD ST, SUITE 200, CHICAGO, IL 60617-3936
(773) 734-3970
(773) 734-6832
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036035346
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01604576
BC/BS PROVIDER #
IL
Enumeration date
07/17/2006
Last updated
03/24/2010
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