Individual
ALEXANDER PORUCZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1861 STURDY RD, VALPARAISO, IN 46383-8017
(219) 548-0360
Mailing address
565 W QUINCY ST UNIT 617, CHICAGO, IL 60661-2903
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10002834A
IN
Other
Enumeration date
10/14/2019
Last updated
04/08/2022
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