Healthcare Provider Details

I. General information

NPI: 1992004162
Provider Name (Legal Business Name): ALEXANDER JOHN TAUCHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2011
Last Update Date: 07/21/2022
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MILWAUKEE AVE
LINCOLNSHIRE IL
60069-3839
US

IV. Provider business mailing address

920 MILWAUKEE AVE
LINCOLNSHIRE IL
60069-3839
US

V. Phone/Fax

Practice location:
  • Phone: 847-866-7846
  • Fax:
Mailing address:
  • Phone: 847-866-7846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036142340
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: