Podolskiy, Aleksandr

Podolskiy, Aleksandr is an individual health care provider with primary practice located at 755 S Milwaukee Ave Suite 164, Libertyville IL 60048. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Podolskiy, Aleksandr can be contacted via phone (847) 918-0430.

Contact Information

Primary practice address
755 S Milwaukee Ave Suite 164 Libertyville IL 60048
Phone: (847) 918-0430
Fax: (847) 918-7850
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036111753 Illinois

Profile Details

NPI number 1619922135
LBN Legal business name Podolskiy, Aleksandr
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Dec 13th, 2021 - about 3 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 1619922135 NPPES
Illinois MEDICAID 036111753

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