Provider Demographics
NPI:1376775940
Name:MENGIN, OLGA MARIA TELGARSKA (MD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:MARIA TELGARSKA
Last Name:MENGIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 E SUPERIOR ST STE 4-2305
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2914
Mailing Address - Country:US
Mailing Address - Phone:312-926-5522
Mailing Address - Fax:312-695-5645
Practice Address - Street 1:250 E SUPERIOR ST STE 4-2305
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-926-5522
Practice Address - Fax:312-695-5645
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1250564552085R0202X
RI149902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0057818OtherSTATE LICENSE NUMBER
MA258674OtherSTATE OF MASSACHUSETTS, BOARD OF REGISTRATION IN MEDICINE