Provider Demographics
NPI:1902124480
Name:ALKALAY, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ALKALAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6676 SOLUTIONS CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6006
Mailing Address - Country:US
Mailing Address - Phone:248-893-3200
Mailing Address - Fax:248-893-2950
Practice Address - Street 1:28455 HAGGERTY RD
Practice Address - Street 2:STE 200
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2982
Practice Address - Country:US
Practice Address - Phone:248-893-3220
Practice Address - Fax:248-893-2951
Is Sole Proprietor?:No
Enumeration Date:2010-05-09
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301097366208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0931998OtherBCBSM PIN
MI4301097366OtherMEDICAL LICS
MI4301097366OtherMEDICAL LICS