Individual
MEGAN A TKACHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027
(262) 670-4000
(262) 670-4001
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34602800
—
WI
01
—
P01087256
RR MEDICARE
WY
Enumeration date
07/10/2006
Last updated
12/04/2024
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