Provider Demographics
NPI:1639296486
Name:COPERNICUS MEDICAL CORPORATION.,LTD.
Entity Type:Organization
Organization Name:COPERNICUS MEDICAL CORPORATION.,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAL
Authorized Official - Middle Name:JACEK
Authorized Official - Last Name:CHOJNACKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-283-9300
Mailing Address - Street 1:5251 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-4634
Mailing Address - Country:US
Mailing Address - Phone:773-283-9300
Mailing Address - Fax:773-283-0098
Practice Address - Street 1:5251 N MILWAUKEE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-4634
Practice Address - Country:US
Practice Address - Phone:773-283-9300
Practice Address - Fax:773-283-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty