Basic Information
| Provider Information | |||||||||
| NPI: | 1821196361 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOVALSKY | ||||||||
| FirstName: | EUGENE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 N CLAREMONT AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606221702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084607444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1431 N CLAREMONT AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606221702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084607444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 05/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085N0700X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0904X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085P0229X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085R0202X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0203X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology | 2085R0204X | 36058443 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085U0001X | 36058443 | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No ID Information.