Ikmd PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

IKMD PLLC

Practice address

18701 N 67TH Ave
Glendale, AZ 85308-7100

Phone

(623) 561-1000

NPI assigned

Jul 3, 2018

Organization subpart

No

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

Authorized official

Name

Igor Kravchenko, MD

Title

Sole Owner

Phone

(602) 395-0718

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530576000000",
    "number": "1700372653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15345 N SCOTTSDALE RD UNIT 3063",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18701 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087100",
            "telephone_number": "623-561-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A",
        "authorized_official_last_name": "KRAVCHENKO",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "602-395-0718",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.