Organization
DR RUSSELL KUBYCHECK SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL M KUBYCHECK M.D. (OWNER/DOCTOR)
(630) 789-0400
Entity
Organization
Contact information
Practice address
333 CHESTNUT STREET, #207, HINSDALE, IL 60521
(630) 789-0400
(630) 789-1504
Mailing address
333 CHESTNUT STREET, #207, HINSDALE, IL 60521
(630) 789-0400
(630) 789-1504
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-056399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056399
—
IL
Enumeration date
12/03/2010
Last updated
12/03/2010
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