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Individual

DR. MILENA IVANOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036139052
IL
2085R0202X
Diagnostic Radiology Physician
257386
MA
2085R0202X
Diagnostic Radiology Physician
66154
WI
2085R0202X
Diagnostic Radiology Physician
D74734
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
058302200
MD
05
1174724264
WI
Enumeration date
05/29/2007
Last updated
05/21/2022
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