Individual
MRS. JOLANTA DZIOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7447 W TALCOTT AVE, SUTE 509, CHICAGO, IL 60631-3745
(773) 792-2939
(773) 792-3214
Mailing address
11252 W ALEXANDRIA LN, WESTCHESTER, IL 60154-5934
(708) 562-5132
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036055387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21609426
BCBS PROVIDER NUMBER
IL
Enumeration date
12/14/2006
Last updated
10/04/2012
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