Provider Demographics
NPI:1649395518
Name:MILIKOVSKY, ALLA (LICAC, DIPLAC)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:MILIKOVSKY
Suffix:
Gender:F
Credentials:LICAC, DIPLAC
Other - Prefix:
Other - First Name:ALLA
Other - Middle Name:
Other - Last Name:MILIKOVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3150 N LAKE SHORE DR
Mailing Address - Street 2:APT 32B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4810
Mailing Address - Country:US
Mailing Address - Phone:773-525-4349
Mailing Address - Fax:773-572-6073
Practice Address - Street 1:3823 N CLARK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2811
Practice Address - Country:US
Practice Address - Phone:773-525-4349
Practice Address - Fax:773-572-6073
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist