Provider Demographics
NPI:1083029375
Name:RIKHMAN, YELENA
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:RIKHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 STANTON DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6840
Mailing Address - Country:US
Mailing Address - Phone:847-293-6777
Mailing Address - Fax:
Practice Address - Street 1:272 STANTON DR
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6840
Practice Address - Country:US
Practice Address - Phone:847-293-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBOARDS ELIGIBLE367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered