Individual
DR. MICHAEL JUTOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6326 N LINCOLN AVE, CHICAGO, IL 60659-1204
(773) 463-4100
(773) 463-4102
Mailing address
6326 N LINCOLN AVE, CHICAGO, IL 60659-1204
(773) 463-4100
(773) 463-4102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036080157
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036080157
—
IL
Enumeration date
08/10/2005
Last updated
09/28/2011
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