Organization
CARDIO PULMONARY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALDEMAR CHODAKOWSKI (OWNER)
(773) 384-4494
Entity
Organization
Contact information
Practice address
2923 N MILWAUKEE AVE, CHICAGO, IL 60618-7404
(773) 384-4494
(773) 384-4422
Mailing address
2923 N MILWAUKEE AVE, CHICAGO, IL 60618-7404
(773) 384-4494
(773) 384-4422
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
194-003475
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
203-000235
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635008
BLUE SHIELD OF IL
IL
Enumeration date
02/23/2009
Last updated
02/24/2009
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