Provider Demographics
NPI: | 1669603858 |
---|---|
Name: | KALNINS, ALEKSANDRS U (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ALEKSANDRS |
Middle Name: | U |
Last Name: | KALNINS |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2650 RIDGE AVE |
Mailing Address - Street 2: | DEPT OF RADIOLOGY |
Mailing Address - City: | EVANSTON |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60201-1057 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-570-2475 |
Mailing Address - Fax: | 847-570-2942 |
Practice Address - Street 1: | 2650 RIDGE AVE |
Practice Address - Street 2: | DEPT OF RADIOLOGY |
Practice Address - City: | EVANSTON |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60201-1057 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-570-2486 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2009-08-05 |
Last Update Date: | 2023-01-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 036141662 | 2085D0003X, 2085R0202X, 2085N0700X |
MI | 4301094847 | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No | 2085D0003X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |