Provider Demographics
NPI:1205931243
Name:BYLEWSKI, JOHN R (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:BYLEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4900 S ARCHER AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632
Mailing Address - Country:US
Mailing Address - Phone:773-767-5950
Mailing Address - Fax:773-767-5946
Practice Address - Street 1:4900 S ARCHER AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632
Practice Address - Country:US
Practice Address - Phone:773-767-5950
Practice Address - Fax:773-767-5946
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2009-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036070127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0031602058OtherBLUE CROSS
C48530Medicare UPIN
IL0031602058OtherBLUE CROSS