Individual
DR. NICHOLAS MICHAEL KOLANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
125052322
IL
2085R0202X
Diagnostic Radiology Physician
4301098589
MI
2085R0202X
Diagnostic Radiology Physician
50104-20
WI
2085R0202X
Diagnostic Radiology Physician
Primary
67438-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125052322
ILLINOIS LICENSE NUMBER, TEMPORARY PHYSICIAN LICENSE
IL
05
—
1427214857
—
WI
Enumeration date
08/05/2008
Last updated
02/01/2024
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