Individual
ANNA IVANENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
800 BIESTERFIELD RD, SUITE 510, ELK GROVE VILLAGE, IL 60007-3361
(847) 981-3660
(847) 956-5108
Mailing address
800 BIESTERFIELD RD, SUITE 510, ELK GROVE VILLAGE, IL 60007-3361
(847) 981-3660
(847) 956-5108
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
36108993
IL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
036108993
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617373
BCBS OF IL
IL
05
—
36108993
—
IL
Enumeration date
03/07/2006
Last updated
04/05/2021
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