Organization
MIDWEST PROSTATE-UROLOGY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD WALTER CHODAK M.D. (DIRECTOR / OWNER)
(312) 969-2989
Entity
Organization
Contact information
Practice address
4646 N MARINE DR, SUITE A5300, CHICAGO, IL 60640-5759
(773) 564-5006
(773) 564-5007
Mailing address
1937 W CORTLAND ST, CHICAGO, IL 60622-1041
(312) 969-2989
(773) 486-5974
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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