Organization Active NPI

Aleksandar Krunic, MD, SC

  • MOHS-Micrographic Surgery Physician
  • Chicago, IL
National Provider Identifier
1801967633
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
036101957 Issued in IL
Legal business name
ALEKSANDAR KRUNIC, MD, SC
Practice address
3000 N Halsted St Ste 620
Chicago, IL 60657-5196
Phone
(773) 871-7000
Fax
(773) 907-6336
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Dr. Aleksandar L Krunic, MDNPI 1891721965
Title
President
Phone
(773) 907-8454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X 036101957 IL Primary

Addresses

Primary practice location

3000 N Halsted St Ste 620
Chicago, IL 60657-5196

Mailing address

3000 N Halsted St Ste 620
Chicago, IL 60657-5196
Phone (773) 871-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070109000015 IL Part B Supplier - Clinic/Group Practice 4688674260 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

5140 N California Ave
Ste 660B
Chicago, IL 60625

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1801967633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-871-7000",
            "fax_number": "773-907-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-871-7000",
            "fax_number": "773-907-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEKSANDAR KRUNIC, MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "KRUNIC",
        "authorized_official_first_name": "ALEKSANDAR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-907-8454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036101957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.