Healthcare Provider Details

I. General information

NPI: 1710470257
Provider Name (Legal Business Name): ALAN AKIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W 22ND ST STE 260
OAK BROOK IL
60523-1947
US

IV. Provider business mailing address

600 W 22ND ST STE 260
OAK BROOK IL
60523-1947
US

V. Phone/Fax

Practice location:
  • Phone: 331-291-8522
  • Fax: 872-345-0298
Mailing address:
  • Phone: 331-291-8522
  • Fax: 872-345-0298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125.072102
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: