Kermitt Alexander, Certified Hair Loss
Specialist, Prosthetics Case Management in Calumet City, IL. Individual provider (NPI-1).
NPI number1043878747
StatusActive
Last updated in NPPESFeb 9, 2021
Details
- NPI
- 1043878747
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kermitt Alexander
- Credential
- Certified Hair Loss
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 29, 2019
- Certification date
- Feb 9, 2021
- Last updated
- Feb 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1744P3200X | Specialist, Prosthetics Case Management | 011.253751 | IL | Yes |
Practice location
1575 Sibley BlvdCalumet City, IL 60409-2304
Phone 708-955-4050
Mailing address
451 Mackinaw AveCalumet City, IL 60409-2514
Phone 708-955-4050
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