Organization
BOLEVIKA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOHDAN KONTSEVYY AS (PRESIDENT)
(773) 510-5063
Entity
Organization
Contact information
Practice address
6157 N SHERIDAN RD, APT 17K, CHICAGO, IL 60660-3089
(773) 510-5063
Mailing address
6157 N SHERIDAN RD, APT 17K, CHICAGO, IL 60660-3089
(773) 510-5063
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
2380000087
IL
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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