IndividualActive
Alexander Kmicikewycz, MD
NPI 1710097779 · Internal Medicine Physician · Palos Heights, IL
Provider details
- NPI number
- 1710097779
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036064794 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
12622 South Harlem Avenue
Palos Heights, IL 60463-1428
Phone: (708) 923-9610
Fax: (708) 923-9613
Approximate (ZIP-level) locationGet directions
Mailing address
12622 South Harlem Avenue
Palos Heights, IL 60463-1428
Registry dates
- Enumerated
- 2006-08-30
- Last updated
- 2021-12-29
- Certified
- 2021-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.