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Individual

ELENA I SIDORENKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0002
(608) 785-0940

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20965
WI
207RG0100X
Gastroenterology Physician
43384
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-29606
MEDICAL LICENSE
KS
05
48105031
CO
Enumeration date
09/29/2006
Last updated
12/23/2021
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