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NPI Code Detail

MEDICARE: GANKA SKERLEVA APN

MEDICARE: GANKA SKERLEVA APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209010938IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326460601
Entity Type Code : Individual
Provider Name (Legal Business Name) : GANKA SKERLEVA APN
Provider Business Mailing Address
First Line : 1300 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1302
Country : US
Telephone Number : 773-751-7850
Fax Number : 773-751-7855
Provider Business Practice Location Address
First Line : 1300 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1302
Country : US
Telephone Number : 773-751-7850
Fax Number : 773-751-7855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2014
Last Update Date : 12/08/2016

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Directions to “ GANKA SKERLEVA APN” Practice Location

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