Provider Demographics
NPI:1922391598
Name:G PIKOVSKI MD S.C.
Entity Type:Organization
Organization Name:G PIKOVSKI MD S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHIYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIKOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-414-9178
Mailing Address - Street 1:609 ROSEDALE RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3948
Mailing Address - Country:US
Mailing Address - Phone:847-414-9178
Mailing Address - Fax:
Practice Address - Street 1:1803 GLENVIEW RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2909
Practice Address - Country:US
Practice Address - Phone:847-657-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-098599261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center