POJ LYSOUVAKON

CHICAGO, IL
NPI1346304946
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: IL  036098561)
Additional Taxonomies2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: IL  036098561)
Enumeration Date2006-12-20
Last Update Date2022-10-11
Business Address
POJ LYSOUVAKON
800 E 55TH ST
CHICAGO, IL 60615
Phone number: 773-702-0660
Mailing Address
POJ LYSOUVAKON
800 E 55TH ST
CHICAGO, IL 60615-4906
Phone number: 773-702-0660