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Individual

DR. PHILLIP A SKOCZELAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 989-1357
(773) 989-5406
Mailing address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 989-1357
(773) 989-5406

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036057792
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036057792-3
IL
Enumeration date
05/16/2006
Last updated
08/02/2010
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