Provider Demographics
NPI:1780610709
Name:AIKENHEAD, JOHN
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:AIKENHEAD
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 1:1039 COLLEGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5795
Mailing Address - Country:US
Mailing Address - Phone:630-462-9772
Mailing Address - Fax:630-462-9788
Practice Address - Street 1:1039 COLLEGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5795
Practice Address - Country:US
Practice Address - Phone:630-462-9772
Practice Address - Fax:630-462-9788
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology