MEDICARE: EVGUENI MINEV M.D.

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	207R00000X	Internal Medicine Physician	4301077053	MI
2	207R00000X	Internal Medicine Physician	036121995	IL
3	207RN0300X	Nephrology Physician	036121995	IL

General Provider Information

NPI Number	:	1922119643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVGUENI MINEV M.D.

Provider Business Mailing Address
First Line	:	120 W 22ND ST STE 200
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1563
Country	:	US
Telephone Number	:	630-573-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W GOLF RD STE 105
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4276
Country	:	US
Telephone Number	:	847-439-8780
Fax Number	:	847-439-8940

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/01/2023

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Directions to “ EVGUENI MINEV M.D.” Practice Location

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