Healthcare Provider Details

I. General information

NPI: 1073041620
Provider Name (Legal Business Name): ILYA ALEKSANDROVSKIY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

6040 GAINFORD RD
NORTH CHESTERFIELD VA
23234-5032
US

V. Phone/Fax

Practice location:
  • Phone: 804-483-0000
  • Fax:
Mailing address:
  • Phone: 347-452-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73100-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number73100-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207QD0401X
TaxonomyDiabetology (Family Medicine) Physician
License Number73100-20
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207QB0505X
TaxonomyDiabetology (Internal Medicine) Physician
License Number73100-20
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101272886
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number73100-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: