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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598767352 | NPPES |
| Illinois | MEDICAID | 036111777 |
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