Kermitt Alexander, CERTIFIED HAIR LOSS

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

011.253751 Issued in IL

Practice address

1575 Sibley Blvd
Calumet City, IL 60409-2304

Phone

(708) 955-4050

NPI assigned

May 29, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1043878747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 MACKINAW AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092514",
            "telephone_number": "708-955-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 SIBLEY BLVD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604092304",
            "telephone_number": "708-955-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "KERMITT",
        "name_prefix": "Mrs.",
        "credential": "CERTIFIED HAIR LOSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "IL",
            "license": "011.253751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayode O Adeoye
• Afzal Ahmad, M.D.
• Gadallah A Alawi
• Nicole Rochelle Albright, O.D.
• Janice Aldrich-French
• Nicole Alexander
• Janine R. Alfirevic, MS/CCC-SLP-L
• Daniela Alvarez, COTA
• Amani Therapy Practice LLC
• Amazing Care Systems Inc

• Prosthetics Case Management in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Prosthetics Case Management in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.