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Individual

DR. YULIA M DEMIDOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1740 W TAYLOR ST, 3200W; MC 515, CHICAGO, IL 60612-7232
(312) 996-4020
(312) 996-4019
Mailing address
1740 W TAYLOR ST, 3200W; MC 515, CHICAGO, IL 60612-7232
(312) 996-4020
(312) 996-4019

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036109413
IL
207L00000X
Anesthesiology Physician
46973
WI
207LP3000X
Pediatric Anesthesiology Physician
036109413
IL
207LP3000X
Pediatric Anesthesiology Physician
46973-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009906261O
HUMANA
05
1306897475
WI
05
34537900
WI
Enumeration date
05/13/2006
Last updated
12/22/2015
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