Individual
GENNADY BOLDETSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1040 S MILWAUKEE AVE, SUITE 100, WHEELING, IL 60090-6373
(847) 366-9518
Mailing address
7975 N NORDICA AVE, NILES, IL 60714-3315
(847) 366-9518
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198001173
IL
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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