Individual
DR. DIANA MNATSAKANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1801 W TAYLOR ST, CHICAGO, IL 60612-4795
(312) 996-6496
Mailing address
200 HAWKINS DR DEPT OF, IOWA CITY, IA 52242-1009
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
036146766
IL
Other
Enumeration date
03/24/2012
Last updated
09/27/2018
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