Individual
MR. PHILIP SEBASTIAN MACIUKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S FIRST AVENUE, BUILDING 103 ROOM 3107, MAYWOOD, IL 60153
(708) 216-9169
(708) 216-1249
Mailing address
2160 S FIRST AVENUE, BUILDING 103 ROOM 3107, MAYWOOD, IL 60153
(708) 216-9169
(708) 216-1249
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125.074702
IL
208VP0000X
Pain Medicine Physician
Primary
036.158461
IL
Other
Enumeration date
04/05/2019
Last updated
06/02/2023
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