Individual
DR. JOHN ANTHONY CIESLAK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2650 RIDGE AVE., DEPT. OF RADIOLOGY, EVANSTON, IL 60201-1057
(847) 570-2942
Mailing address
2650 RIDGE AVE., DEPT. OF RADIOLOGY, EVANSTON, IL 60201-1057
(847) 570-2942
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.142179
IL
2085R0204X
Vascular & Interventional Radiology Physician
036142179
IL
Other
Enumeration date
06/07/2011
Last updated
04/13/2022
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