Provider Demographics
NPI:1932676418
Name:ALEX J MD LLC
Entity Type:Organization
Organization Name:ALEX J MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JOVANOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-999-9016
Mailing Address - Street 1:355 N CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1207
Mailing Address - Country:US
Mailing Address - Phone:847-757-2376
Mailing Address - Fax:847-881-0822
Practice Address - Street 1:355 N CANAL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1207
Practice Address - Country:US
Practice Address - Phone:847-757-2376
Practice Address - Fax:847-881-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty