Individual
MARIAH TKACHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4956 W IRVING PARK RD, CHICAGO, IL 60641-2640
(773) 725-5835
Mailing address
1503 E THACKER ST, DES PLAINES, IL 60016-6431
(773) 870-0043
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
227011440
IL
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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