Provider Demographics
NPI:1588914105
Name:R. PHILIP SZWAJKUN MD SC
Entity type:Organization
Organization Name:R. PHILIP SZWAJKUN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:SZWAJKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-884-7920
Mailing Address - Street 1:9229 MASSASOIT AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1657
Mailing Address - Country:US
Mailing Address - Phone:773-884-7920
Mailing Address - Fax:
Practice Address - Street 1:2701 W 68TH ST
Practice Address - Street 2:2ND FL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1813
Practice Address - Country:US
Practice Address - Phone:773-884-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360846502086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty