Pankov, Andrei Vladimir
Pankov, Andrei Vladimir is an individual health care provider with primary practice located at 1877 W Downer Pl , Aurora IL 60506-7302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Pankov, Andrei Vladimir can be contacted via phone (630) 906-5120.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 036127557 | Illinois |
Profile Details
| NPI number | 1225285703 |
|---|---|
| LBN Legal business name | Pankov, Andrei Vladimir |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2008 |
| Last updated | Jul 30th, 2012 - about 12 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225285703 | NPPES |
| Illinois | MEDICAID | 036127557 |
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