Provider Demographics
NPI:1649670571
Name:MEDVEDOFSKY, DIEGO ANDRES (MD)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:ANDRES
Last Name:MEDVEDOFSKY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5050 S LAKE SHORE DR
Mailing Address - Street 2:APARTMENT 3112
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3282
Mailing Address - Country:US
Mailing Address - Phone:312-721-7525
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE STE MC6080
Practice Address - Street 2:UNIVERSITY OF CHICAGO MEDICAL CENTER, CARDIOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1641
Practice Address - Country:US
Practice Address - Phone:773-834-5418
Practice Address - Fax:773-702-1385
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2016-02-10
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Provider Licenses
StateLicense IDTaxonomies
IL125.065043207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease