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General NPI Number Information
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NPI Number | 1568984789
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Entity Type | Individual
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Provider Name | VOLODYMYR MANKO MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 1650 W HARRISON ST STE 466
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City | CHICAGO
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State | IL
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Zip | 60612-3800
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Country | US
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Telephone | 312-942-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1727 S INDIANA AVE APT 105
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City | CHICAGO
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State | IL
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Zip | 60616-1347
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Country | US
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Telephone | 224-522-0021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 73618-20
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License Number State | WI
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