Individual
ALEXANDER JAN KIETURAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4835 BELMONT RD APT 8, DOWNERS GROVE, IL 60515-3249
(937) 371-6331
Mailing address
4835 BELMONT RD APT 8, DOWNERS GROVE, IL 60515-3249
(937) 371-6331
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
316227
NY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2017
Last updated
09/18/2023
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