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NPI Code Detail

MEDICARE: ALEXANDRA BOSMA

MEDICARE: ALEXANDRA BOSMA
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
1101YM0800XMental Health Counselor180009366IL

General Provider Information

NPI Number : 1013331040
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA BOSMA
Provider Business Mailing Address
First Line : 1248 S WALNUT AVE
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-3056
Country : US
Telephone Number : 847-461-9707
Fax Number :
Provider Business Practice Location Address
First Line : 939 W NORTH AVE STE 750
Second Line :
City : CHICAGO
State : IL
Zip : 60642-7142
Country : US
Telephone Number : 847-461-9707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2014
Last Update Date : 06/08/2021

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Directions to “ ALEXANDRA BOSMA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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