Organization
OSIPOVA SURGICAL SERVICE CORPORATION
Active
Organization
OSIPOVA SURGICAL SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA OSIPOVA MD (OWNER)
(773) 561-7911
Entity
Organization
Contact information
Practice address
331 W SURF ST STE 714, CHICAGO, IL 60657-7227
(773) 561-7911
Mailing address
1S376 SUMMIT AVE STE 4C, OAKBROOK TERRACE, IL 60181-3966
(630) 424-1122
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086X0206X
Surgical Oncology Physician
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
08/09/2019
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