Individual
DR. ALEX HUTNIK I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
809 W DETWEILLER DR, SUITE 805A, PEORIA, IL 61615-2149
(309) 692-1320
(309) 692-1355
Mailing address
17748 WESTBROOK DR, ORLAND PARK, IL 60467-8552
(708) 703-1099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-029921
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019029921
—
IL
Enumeration date
07/14/2014
Last updated
07/14/2014
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