Provider Demographics
NPI:1861533366
Name:JANKE, IGOR EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:IGOR
Middle Name:EDWARD
Last Name:JANKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17230 TWIN MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-7813
Mailing Address - Country:US
Mailing Address - Phone:330-703-4955
Mailing Address - Fax:
Practice Address - Street 1:21001 SYCOLIN RD STE 360
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4331
Practice Address - Country:US
Practice Address - Phone:038-587-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2022-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012739952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry