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Individual

OLEH PALY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
34905 N LAKE MATTHEWS TRL, INGLESIDE, IL 60041-9480
(773) 767-8283
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-4600
(773) 767-8320

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036072020
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036072020
IL
01
04905190
BLUE SHIELD
IL
Enumeration date
07/23/2006
Last updated
08/26/2009
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