Provider Demographics
NPI:1699921221
Name:DIDENKO, TARAS W (MD)
Entity type:Individual
Prefix:DR
First Name:TARAS
Middle Name:W
Last Name:DIDENKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 59566
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60159-0566
Mailing Address - Country:US
Mailing Address - Phone:847-496-4525
Mailing Address - Fax:847-660-2958
Practice Address - Street 1:999 N PLAZA DR STE 270
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5493
Practice Address - Country:US
Practice Address - Phone:847-496-4525
Practice Address - Fax:847-660-2958
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1250502772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry