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Individual

MARIAN KOWALCZYK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3115 N HARLEM AVE, STE 202, CHICAGO, IL 60634-4683
(773) 282-4793
(773) 282-4844
Mailing address
3020 EDGEMONT LN, PARK RIDGE, IL 60068-2155
(773) 282-4793
(773) 282-4844

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-101289
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036101289
IL
Enumeration date
07/23/2006
Last updated
01/03/2020
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