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Organization

PARKVIEW EAR, NOSE & THROAT CLINIC, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JANA PODZIMEK D.O. (PRESIDENT / OWNER)
(309) 347-5946
Entity
Organization

Contact information

Practice address
112 PARK RIDGE LN, PEKIN, IL 61554-3900
(309) 347-5946
(309) 347-2755
Mailing address
112 PARK RIDGE LN, PEKIN, IL 61554-3900
(309) 347-5946
(309) 347-2755

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9032056
BLUE SHEILD PROVIDER #
IL
01
IL101
JOHN DEERE
IL
Enumeration date
08/30/2006
Last updated
08/22/2020
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