Provider Demographics
NPI:1386858710
Name:DUDAS, BOHDAN GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:BOHDAN
Middle Name:GEORGE
Last Name:DUDAS
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 1:421 JASON LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-2071
Mailing Address - Country:US
Mailing Address - Phone:847-995-0658
Mailing Address - Fax:
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 358
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-775-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILBD3845837OtherDEA
ILBD3845837OtherDEA
ILE95399Medicare UPIN