Provider Demographics
NPI:1164642286
Name:KARIKOMI, ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:KARIKOMI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N LA SALLE ST
Mailing Address - Street 2:SUITE 155
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3702
Mailing Address - Country:US
Mailing Address - Phone:312-236-7538
Mailing Address - Fax:312-236-1205
Practice Address - Street 1:2 N LA SALLE ST
Practice Address - Street 2:SUITE 155
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3702
Practice Address - Country:US
Practice Address - Phone:312-236-7538
Practice Address - Fax:312-236-1205
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007193152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL3529001Medicare PIN