Organization
ALEX J MD LLC
Active
Other names
The Custom Medical Group, DERMACARE Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDAR JOVANOVICH MD (OWNER/CHIEF MEDICAL OFFICER)
(847) 999-9016
Entity
Organization
Contact information
Practice address
355 N CANAL ST, CHICAGO, IL 60606-1207
(847) 757-2376
(847) 881-0822
Mailing address
355 N CANAL ST, CHICAGO, IL 60606-1207
(847) 757-2376
(847) 881-0822
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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