MEDICARE: VIRINA AKHNOUKH

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1235077728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRINA AKHNOUKH

Provider Business Mailing Address
First Line	:	8019 MALLOW DR
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-2696
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3231 EUCLID AVE
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402-3471
Country	:	US
Telephone Number	:	877-834-7264
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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