Individual provider · Type 1 NPI

Pavel Krotenkov, MD, PhD

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1205209772 Active

Practice location

1740 W Taylor St
Chicago, IL 60612-7232

Call (866) 600-2273 Map

Mailing address

2136 W Bowler St
Chicago, IL 60612-4202

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X125066090 (IL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1205209772

Pavel Krotenkov, MD, PhD's National Provider Identifier is 1205209772, issued on Nov 5, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Nov 5, 2015.