Provider Demographics
NPI:1679549661
Name:MENSHEHA, OKSANA (MD)
Entity type:Individual
Prefix:DR
First Name:OKSANA
Middle Name:
Last Name:MENSHEHA
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 1:1117 S MILWAUKEE AVE
Mailing Address - Street 2:FORUM SQUARE A-10
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3798
Mailing Address - Country:US
Mailing Address - Phone:847-367-6780
Mailing Address - Fax:847-367-6861
Practice Address - Street 1:1117 S MILWAUKEE AVE
Practice Address - Street 2:FORUM SQUARE A-10
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3798
Practice Address - Country:US
Practice Address - Phone:847-367-6780
Practice Address - Fax:847-367-6861
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36053536207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004900798OtherBLUE CROSS BLUE SHIELD
ILP00246085OtherRAILROAD MEDICARE
IL535994001OtherDMEPOS SUPPLIER NUMBER
IL0004900798OtherBLUE CROSS BLUE SHIELD
ILC38314Medicare UPIN