Maslovsky, Semyon

Maslovsky, Semyon is an sole proprietor health care provider with primary practice located at 500 Park Ave Ste 104, Lake Villa IL 60046-6556. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Maslovsky, Semyon can be contacted via phone (847) 245-8700.

Contact Information

Primary practice address
500 Park Ave Ste 104 Lake Villa IL 60046-6556
Fax: (847) 245-8771
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036077057 Illinois

Profile Details

NPI number 1508855040
LBN Legal business name Maslovsky, Semyon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2005
Last updated Oct 14th, 2008 - about 16 years ago

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 1508855040 NPPES
Illinois MEDICAID 036077057

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