Provider Demographics
NPI:1609119932
Name:KARAGODIN, ILYA M (MD)
Entity Type:Individual
Prefix:
First Name:ILYA
Middle Name:M
Last Name:KARAGODIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9650 GROSS POINT RD STE 4900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5080
Mailing Address - Country:US
Mailing Address - Phone:847-864-3278
Mailing Address - Fax:847-676-1727
Practice Address - Street 1:9650 GROSS POINT RD STE 4900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5080
Practice Address - Country:US
Practice Address - Phone:847-864-3278
Practice Address - Fax:847-676-1727
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2021-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036142317207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease