Provider Demographics
NPI:1760144083
Name:VIKTORIYA O DOTCHEV MD SC
Entity Type:Organization
Organization Name:VIKTORIYA O DOTCHEV MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTCHEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-630-4735
Mailing Address - Street 1:17W165 LEAHY RD
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4513
Mailing Address - Country:US
Mailing Address - Phone:847-630-4735
Mailing Address - Fax:
Practice Address - Street 1:985 S BUFFALO GROVE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3702
Practice Address - Country:US
Practice Address - Phone:847-630-4735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty