Search › Wisconsin › 183500000X
Yelena Ivanova
NPI 1265754485 · on the registry since 2010 · sole proprietor
Practice
- Address
- 4100 52nd St
Kenosha, WI 53144 - Phone
- (262) 658-0902
- Fax
- (262) 658-0560
- Organisation at this address
- Sears Holdings Corporation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2010-02-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin