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ALEXANDER MEDVEDEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-4180
(847) 618-2709
Mailing address
3857 MAPLE AVE, NORTHBROOK, IL 60062-4944
(425) 503-5069

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125057105
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036128731
STATE LICENSE
IL
Enumeration date
07/02/2009
Last updated
12/16/2020
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