Individual
EMA AVDAGIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
836 W WELLINGTON AVE FL 5, CHICAGO, IL 60657-5147
(773) 296-8000
Mailing address
922 W WASHINTON BLVD, UNIT 916, CHICAGO, IL 60607
(646) 943-2886
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036161226
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2017
Last updated
10/26/2022
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