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Individual

KRYSTSINA DZMITRUKOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1500 S FAIRFIELD AVE, CHICAGO, IL 60608-1782
(773) 542-2000
Mailing address
1500 S CALIFORNIA AVE., CHICAGO, IL 60608

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
03/31/2016
Last updated
06/14/2016
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