Organization
WI SHMH SC
Active
Organization
WI SHMH SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTYNA KOLAREV (VICE PRESIDENT)
(773) 332-7539
Entity
Organization
Contact information
Practice address
18740 W BLUEMOUND RD, BROOKFIELD, WI 53045-2936
(847) 221-6040
Mailing address
5454 FARGO AVE, SKOKIE, IL 60077-3210
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
12/22/2025
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