Provider Demographics
NPI:1174747786
Name:HANKEWYCH, KSENIA OLEXANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:KSENIA
Middle Name:OLEXANDRA
Last Name:HANKEWYCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 W RICE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4742
Mailing Address - Country:US
Mailing Address - Phone:773-531-2770
Mailing Address - Fax:
Practice Address - Street 1:2050 PFINGSTEN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1324
Practice Address - Country:US
Practice Address - Phone:847-832-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51289966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist