ILYA A KHOTIMSKY

FOND DU LAC, WI
NPI1245563329
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: WI  56854)
Additional Taxonomies207L00000X Anesthesiology
(Licence: WI  56854-20)
207LC0200X Anesthesiology, Critical Care Medicine
(Licence: WI  56854-20)
Enumeration Date2009-09-08
Last Update Date2021-12-30
Business Address
ILYA A KHOTIMSKY M.D.
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-929-2300
Mailing Address
ILYA A KHOTIMSKY M.D.
420 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 929-926-8340