Provider Demographics
NPI:1205023140
Name:OLEYNIKOV, ALEXANDER (ARDMS)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:OLEYNIKOV
Suffix:
Gender:M
Credentials:ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2420
Mailing Address - Country:US
Mailing Address - Phone:847-223-9494
Mailing Address - Fax:847-205-9722
Practice Address - Street 1:1215 OLD MCHENRY RD
Practice Address - Street 2:SUITE 130A
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1370
Practice Address - Country:US
Practice Address - Phone:847-223-9494
Practice Address - Fax:847-205-9722
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL32953246W00000X
IL32952247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other