Provider Demographics
NPI:1326019407
Name:LANSKY, OLGA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:LANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 S MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5021
Mailing Address - Country:US
Mailing Address - Phone:847-520-8909
Mailing Address - Fax:847-520-8929
Practice Address - Street 1:6420 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5253
Practice Address - Country:US
Practice Address - Phone:773-973-6100
Practice Address - Fax:773-262-4882
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-090217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-090217Medicaid
IL036-090217Medicaid