Provider Demographics
NPI:1306400437
Name:OPALA, ADRIAN ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:ROBERT
Last Name:OPALA
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 1:303 E. CHICAGO AVE.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4296
Mailing Address - Country:US
Mailing Address - Phone:312-503-3936
Mailing Address - Fax:312-503-3951
Practice Address - Street 1:303 E. CHICAGO AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4296
Practice Address - Country:US
Practice Address - Phone:312-503-3936
Practice Address - Fax:312-503-3951
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program