Alexander W. Kmicikewycz,md
Internal Medicine in Palos Heights, IL. Organization (NPI-2).
NPI number1134397441
StatusActive
Last updated in NPPESFeb 20, 2008
Details
- NPI
- 1134397441
- Entity type
- Organization (NPI-2)
- Legal business name
- Alexander W. Kmicikewycz,md
- Organization subpart
- No
- Enumeration date
- Feb 20, 2008
- Last updated
- Feb 20, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
12622 S Harlem AvePalos Heights, IL 60463-1428
Phone 708-923-9610
Mailing address
12622 S Harlem AvePalos Heights, IL 60463-1428
Phone 708-923-9610
Authorized official
Alexander Wolodymyr Kmicikewycz
Owner
7089239610
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