Organization
BORYS SUMYK, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORYS SUMYK M.D. (PRESIDENT)
(708) 452-6539
Entity
Organization
Contact information
Practice address
1225 WEST LAKE STREET, WESTLAKE HOSPITAL, MELROSE PARK, IL 60160
(708) 452-6539
(708) 452-2158
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(708) 452-6539
(708) 452-2158
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036065996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617523
BLUE SHIELD
IL
05
—
036065996
—
IL
01
—
110018587
RAILROAD MEDICARE
—
Enumeration date
07/16/2006
Last updated
04/09/2009
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