Individual
TARAS MASNYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
25 N WINFIELD RD, ASP #500, WINFIELD, IL 60190
(630) 933-4056
(630) 933-4057
Mailing address
25 N WINFIELD RD, ASP #500, WINFIELD, IL 60190-1222
(630) 933-4056
(630) 933-4057
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036-098187
IL
207T00000X
Neurological Surgery Physician
10794
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
CDPG BLUE CROSS GROUP NO.
—
05
—
036098187
—
IL
01
—
206147
CDPG MEDICARE GROUP NO.
—
Enumeration date
11/13/2006
Last updated
06/26/2018
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