Healthcare Provider Details

I. General information

NPI: 1255505608
Provider Name (Legal Business Name): DINAS ALEKSONIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10604 SOUTHWEST HWY STE 107
CHICAGO RIDGE IL
60415-2717
US

IV. Provider business mailing address

11900 SOUTHWEST HWY
PALOS PARK IL
60464-1200
US

V. Phone/Fax

Practice location:
  • Phone: 708-422-0636
  • Fax: 708-371-9330
Mailing address:
  • Phone: 708-274-4900
  • Fax: 708-274-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036.120.401
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036120401
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: