Individual
DR. OKSANA MENSHEHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
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
207W00000X
Ophthalmology Physician
Primary
36053536
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004900798
BLUE CROSS BLUE SHIELD
IL
01
—
535994001
DMEPOS SUPPLIER NUMBER
IL
01
—
P00246085
RAILROAD MEDICARE
IL
Enumeration date
02/28/2006
Last updated
12/15/2021
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