Individual
ALEXANDRE DEREVIANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1811 ARKANSAS AVE, GREAT LAKES, IL 60088-4244
(401) 480-9807
(847) 733-5827
Mailing address
1811 ARKANSAS AVE, GREAT LAKES, IL 60088-4244
(401) 480-9807
(847) 733-5827
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238000408
LICENSE NUMBER
IL
Enumeration date
06/16/2014
Last updated
06/19/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us