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Individual

VADZIM CHYZHYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
409 W OAK ST, CARBONDALE, IL 62901
(618) 529-4455
(618) 351-1287
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036.137880
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036.137880
STATE PHYSICIAN LICENSE
IL
Enumeration date
06/10/2014
Last updated
10/06/2021
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