MEDICARE: ALEKSANDR DEKHTYAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036110249	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851391155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEKSANDR DEKHTYAR MD

Provider Business Mailing Address
First Line	:	614 MARTIN LN
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-3633
Country	:	US
Telephone Number	:	224-489-3888
Fax Number	:	847-728-2101

Provider Business Practice Location Address
First Line	:	2500 W HIGGINS RD
Second Line	:	SUITE 815
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-7220
Country	:	US
Telephone Number	:	224-489-3888
Fax Number	:	847-728-2101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/13/2013

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