Individual
DR. JOHN E PODZAMSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 E 6TH ST, MINONK, IL 61760-1308
(309) 432-2441
(309) 432-3711
Mailing address
200 E 6TH ST, MINONK, IL 61760-1308
(309) 432-2441
(309) 432-3711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036035223
IL
207Q00000X
Family Medicine Physician
Primary
036055223
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055223
—
IL
01
—
10215099
BCBS
IL
Enumeration date
12/07/2005
Last updated
09/07/2012
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