Individual
MRS. KERMITT ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
1575 SIBLEY BLVD, CALUMET CITY, IL 60409-2304
(708) 955-4050
Mailing address
451 MACKINAW AVE, CALUMET CITY, IL 60409-2514
(708) 955-4050
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
011.253751
IL
Other
Enumeration date
05/29/2019
Last updated
02/09/2021
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