# ALEX J MD LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Custom Medical Group, DERMACARE Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932676418
- **Authorized official:** DR. ALEXANDAR JOVANOVICH MD (OWNER/CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (847) 999-9016

## Contact information

- **Practice address:** 355 N CANAL ST, CHICAGO, IL 60606-1207
- **Practice address phone:** (847) 757-2376
- **Practice address fax:** (847) 881-0822
- **Mailing address:** 355 N CANAL ST, CHICAGO, IL 60606-1207
- **Mailing address phone:** (847) 757-2376
- **Mailing address fax:** (847) 881-0822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/01/2018
- **Last updated:** 11/01/2018