Provider Demographics
NPI:1679198584
Name:KAMENSKY, OLIVIA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:LOUISE
Last Name:KAMENSKY
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:CHILDREN'S HOSPITAL OUTPATIENT CENTER
Mailing Address - Street 2:14 MEDICAL PARK SUITE 400
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-6155
Mailing Address - Fax:803-434-6969
Practice Address - Street 1:1750 W HARRISON ST STE 108
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3825
Practice Address - Country:US
Practice Address - Phone:312-942-7802
Practice Address - Fax:312-942-4201
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL84412208000000X
IL036.165422207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics