| Doctor Name: | DR. PHILLIP A SKOCZELAS |
| NPI Number: | 1548212020 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 036057792 |
| Business Practice Address: | 5025 N Paulina St Chicago, IL - 606402772 |
| Business Phone Number: | 7739891357 |
| Business Fax Number: | 7739895406 |
| Mailing Address: | 5025 N Paulina St, CHICAGO |
| State: | IL |
| Postal Code: | 606402772 |
| Phone Number: | 7739891357 |
| Fax Number: | 7739895406 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 08/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036057792 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |