Organization
EUGENIA GROCHOWSKA MD
Active
Other names
Eugenia Grochowska MD
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENIA GROCHOWSKA M.D. (OWNER)
(773) 545-5252
Entity
Organization
Contact information
Practice address
5647 W LAWRENCE AVE, CHICAGO, IL 60630-3219
(773) 545-5252
(773) 545-5671
Mailing address
5647 W LAWRENCE AVE, CHICAGO, IL 60630-3219
(773) 545-5252
(773) 545-5671
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062717
—
IL
01
—
21609795
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
06/13/2012
Last updated
06/13/2012
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