Individual
VITALIY DUSHNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 326-1293
Mailing address
4411 FARMINGTON LN, JOHNSBURG, IL 60051-5136
(847) 772-3205
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.079652
IL
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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