Provider Demographics
NPI:1033510615
Name:OBOLSKY, EDUARD (MD)
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:
Last Name:OBOLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 OAK ST APT 301
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2559
Mailing Address - Country:US
Mailing Address - Phone:847-501-3658
Mailing Address - Fax:
Practice Address - Street 1:812 OAK ST APT 301
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2559
Practice Address - Country:US
Practice Address - Phone:847-501-3658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360684422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology