Organization
OKSANA MENSHEHA, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OKSANA MENSHEHA M.D. (OWNER)
(847) 367-6780
Entity
Organization
Contact information
Practice address
1117 S MILWAUKEE AVE, FORUM SQUARE A-10, LIBERTYVILLE, IL 60048-3798
(847) 367-6780
(847) 367-6861
Mailing address
1117 S MILWAUKEE AVE, FORUM SQUARE A-10, LIBERTYVILLE, IL 60048-3798
(847) 367-6780
(847) 367-6861
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
3603536
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004900798
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/07/2007
Last updated
06/26/2008
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