Alex J MD LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ALEX J MD LLC

Doing business as

DERMACARE Medical Group
The Custom Medical Group

Practice address

355 N Canal St
Chicago, IL 60606-1207

Phone

(847) 757-2376

Fax

(847) 881-0822

NPI assigned

Nov 1, 2018

Last updated

Nov 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alexandar Jovanovich, MDNPI 1588959662

Title

Owner/Chief Medical Officer

Phone

(847) 999-9016

Specialties & licenses 2

Addresses

Other names 2

• DERMACARE Medical Group Doing business as
• The Custom Medical Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexandar Jovanovich, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1588959662
  NPD (past) Authorized official

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1932676418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 N CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061207",
            "telephone_number": "847-757-2376",
            "fax_number": "847-881-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061207",
            "telephone_number": "847-757-2376",
            "fax_number": "847-881-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX J MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "JOVANOVICH",
        "authorized_official_first_name": "ALEXANDAR",
        "authorized_official_title_or_position": "OWNER/CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "847-999-9016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DERMACARE Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Custom Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.