Ivanchenko, Andrew

Ivanchenko, Andrew is an individual health care provider with primary practice located at 985 S. Buffalo Grove Road , Buffalo Grove IL 60089. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Ivanchenko, Andrew can be contacted via phone (847) 681-1161.

Contact Information

Primary practice address
985 S. Buffalo Grove Road Buffalo Grove IL 60089
Phone: (847) 681-1161
Fax: (847) 681-1161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 36111777 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36111777 Illinois

Profile Details

NPI number 1598767352
LBN Legal business name Ivanchenko, Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jun 19th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598767352 NPPES
Illinois MEDICAID 036111777

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