Provider Demographics
NPI:1083662795
Name:SZYFER, MALGORZATA (MD)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:SZYFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N. CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634
Mailing Address - Country:US
Mailing Address - Phone:773-777-2800
Mailing Address - Fax:773-777-2801
Practice Address - Street 1:3401 N. CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634
Practice Address - Country:US
Practice Address - Phone:773-777-2800
Practice Address - Fax:773-777-2801
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036114297Medicaid
ILI44604Medicare UPIN
ILK22248Medicare ID - Type UnspecifiedPPMG
ILK23445Medicare ID - Type UnspecifiedADH
IL036114297Medicaid