Individual
MR. BOGDAN DERYLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2608 W ADDISON ST, CHICAGO, IL 60618-5905
(312) 654-2700
(866) 954-5804
Mailing address
210 S DESPLAINES ST, CHICAGO, IL 60661-5500
(312) 654-2720
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
22935
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122336
—
IL
Enumeration date
04/01/2006
Last updated
11/22/2024
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