Organization
CORDIAL MEDICAL CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL KHODARKOVSKIY M.D. (PRESIDENT)
(224) 392-3643
Entity
Organization
Contact information
Practice address
333 E IL ROUTE 83 STE 105, MUNDELEIN, IL 60060-4278
(847) 970-9922
(847) 970-9955
Mailing address
333 E IL ROUTE 83 STE 105, MUNDELEIN, IL 60060-4278
(847) 970-9922
(847) 970-9955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-107538
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-107538
PHYSICIAN LICENSE NO.
IL
01
—
042-618285
CORPORATION LICENSE NO.
IL
Enumeration date
04/25/2006
Last updated
08/13/2023
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