Provider Demographics
NPI:1376682476
Name:OBOLSKY, ALEXANDER EDUARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:EDUARD
Last Name:OBOLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:134 NORTH LASALLE STREET
Mailing Address - Street 2:SUITE 1810
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602
Mailing Address - Country:US
Mailing Address - Phone:312-456-4343
Mailing Address - Fax:312-456-8304
Practice Address - Street 1:134 NORTH LASALLE STREET
Practice Address - Street 2:SUITE 1810
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602
Practice Address - Country:US
Practice Address - Phone:312-456-4343
Practice Address - Fax:312-456-8304
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360810742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry