Provider Demographics
NPI:1104858703
Name:PODRAZIK, KARLA H (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:H
Last Name:PODRAZIK
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 1:1200 S YORK RD
Mailing Address - Street 2:3250
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5626
Mailing Address - Country:US
Mailing Address - Phone:630-758-8885
Mailing Address - Fax:630-758-8876
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:3250
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-758-8885
Practice Address - Fax:630-758-8876
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036078731207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036078731Medicaid
L10031Medicare PIN