| Yevgeny Odessky Mdsc | |
|
4860 Oakton St Skokie IL 60077-2953 | |
| (847) 329-0470 | |
| (847) 329-0472 |
| Full Name | Yevgeny Odessky Mdsc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4860 Oakton St, Skokie, Illinois |
| Authorized Official Name and Position | Yevgeny Odessky (PRESIDENT) |
| Authorized Official Contact | 8473290470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yevgeny Odessky Mdsc 4860 Oakton St Skokie IL 60077-2953 Ph: (847) 329-0470 | Yevgeny Odessky Mdsc 4860 Oakton St Skokie IL 60077-2953 Ph: (847) 329-0470 |
| NPI Number | 1336329580 |
|---|---|
| Provider Enumeration Date | 11/05/2007 |
| Last Update Date | 12/11/2009 |
| Medicare PECOS PAC ID | 6103874334 |
|---|---|
| Medicare Enrollment ID | O20050105000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336329580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036089618 (Illinois) | Primary |
| Provider Name | Yevgeny Odessky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912018599 PECOS PAC ID: 6002864238 Enrollment ID: I20050107000034 |
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