Organization
TARAS W. DIDENKO, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARAS W. DIDENKO MD (OWNER OF ENTITY)
(312) 810-6223
Entity
Organization
Contact information
Practice address
999 N PLAZA DR STE 270, SCHAUMBURG, IL 60173-5493
(847) 496-4525
(847) 660-2859
Mailing address
PO BOX 59566, SCHAUMBURG, IL 60159-0566
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699921221
INDIVIDUAL NPI
IL
Enumeration date
05/19/2011
Last updated
04/14/2023
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