Provider Demographics
NPI:1841598851
Name:CLEMENTI, ALFRED JOSEPH
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:JOSEPH
Last Name:CLEMENTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 W HADDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-6617
Mailing Address - Country:US
Mailing Address - Phone:847-359-3119
Mailing Address - Fax:847-359-3019
Practice Address - Street 1:1320 W HADDINGTON CT
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6617
Practice Address - Country:US
Practice Address - Phone:847-359-3119
Practice Address - Fax:847-359-3019
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.037996174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist