Provider Demographics
NPI:1417094970
Name:TUDORIU, POMPILIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:POMPILIA
Middle Name:C
Last Name:TUDORIU
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 1:233 E. ERIE ST. #204
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2910
Mailing Address - Country:US
Mailing Address - Phone:312-496-3340
Mailing Address - Fax:312-500-5118
Practice Address - Street 1:233 E. ERIE ST. #204
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2910
Practice Address - Country:US
Practice Address - Phone:312-496-3340
Practice Address - Fax:312-500-5118
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL77918Medicare UPIN