Individual
ALEKSANDR PODOLSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 S MILWAUKEE AVE, SUITE 164, LIBERTYVILLE, IL 60048
(847) 918-0430
(847) 918-7850
Mailing address
PO BOX 5979, BUFFALO GROVE, IL 60089-5979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036111753
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111753
—
IL
Enumeration date
05/23/2006
Last updated
12/13/2021
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