Derylo, Bogdan

Derylo, Bogdan is an individual health care provider with primary practice located at 2608 W Addison St , Chicago IL 60618-5905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Derylo, Bogdan can be contacted via phone (312) 654-2700.

Contact Information

Primary practice address
2608 W Addison St Chicago IL 60618-5905
Phone: (312) 654-2700
Fax: (866) 954-5804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 22935 Nebraska

Profile Details

NPI number 1447211966
LBN Legal business name Derylo, Bogdan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2006
Last updated Jun 27th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447211966 NPPES
Illinois MEDICAID 036122336

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