Individual
JAROSLAV TYMOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2515 W CHICAGO AVE, CHICAGO, IL 60622-4516
(773) 697-7946
(312) 864-9542
Mailing address
619 N CAMPBELL AVE, CHICAGO, IL 60612-1101
(773) 398-3351
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036-116592
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036116592
IL
Other
Enumeration date
07/21/2009
Last updated
04/30/2021
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