Individual
ALEXANDER KICHAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
0 S 050 WINFIELD ROAD, SUITE 120, WINFIELD, IL 60190
(630) 653-4743
(630) 653-4912
Mailing address
2400 N CRESCENT LN, AURORA, IL 60504-6016
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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