Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038-008370 | IL |
NPI | 1003936105 |
---|---|
Provider Name | Alena Janine Kalamaris |
First Address | Schaumburg, IL 60193-3815 |
Second Address | Schaumburg, IL 60193-3815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 08/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01632517 | BCBS PROVIDER NUMBER (01) | IL |
H71640 | (02) | IL |