Individual
ELENA KORNIYCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10400 75TH ST, SUITE 315, KENOSHA, WI 53142-7884
(262) 948-7815
(262) 948-7816
Mailing address
10400 75TH ST, SUITE 315, KENOSHA, WI 53142-7884
(262) 948-7815
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
54938-20
WI
2084N0600X
Clinical Neurophysiology Physician
54938-20
WI
Other
Enumeration date
05/24/2007
Last updated
11/13/2012
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