NPI 1275964918 · live from the CMS NPI Registry
Aleksandr Komarov Dpm LLC
Podiatrist in Chicago, IL. National Provider Identifier 1275964918, active.
NPI record
| NPI | 1275964918 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 1360 N Lake Shore Dr Apt 708, Chicago, IL 60610 |
| Practice phone | 248-787-3625 |
| Enumerated | December 5, 2013 |
| Last updated | October 10, 2019 |
| Authorized official | Aleksandr Komarov, Ceo, Sole Member |
| Other names | Lansing Foot & Ankle |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | — |
| Podiatrist primary | 213E00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.