Basic Information
| Provider Information | |||||||||
| NPI: | 1003146267 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PYSLAR | ||||||||
| FirstName: | ANATOLIY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9350 SKOKIE BLVD | ||||||||
| Address2: | #308 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162554900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3333 GREEN BAY RD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600643095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475783000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2010 | ||||||||
| LastUpdateDate: | 08/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 036130419 | IL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.