Basic Information
| Provider Information | |||||||||
| NPI: | 1770520033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TALEVSKI | ||||||||
| FirstName: | ALEKSANDAR | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 757 45TH AVE | ||||||||
| Address2: | STE. 201 | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463212911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2199342461 | ||||||||
| FaxNumber: | 2199342478 | ||||||||
| Practice Location | |||||||||
| Address1: | 7905 CALUMET AVE | ||||||||
| Address2: | HAMMOND CLINIC LLC | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463211215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198365800 | ||||||||
| FaxNumber: | 2198367214 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 71002127A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.