MEDICARE: ALEXANDRIA FERGUSON

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	225100000X	Physical Therapist	CP052388T	GA
2	225100000X	Physical Therapist	PTH11340	AL

General Provider Information

NPI Number	:	1093406217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA FERGUSON

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5815 WINDWARD PKWY STE 208
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4202
Country	:	US
Telephone Number	:	687-566-8091
Fax Number	:

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

Provider Enumeration Date	:	05/18/2023
Last Update Date	:	06/01/2026

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Directions to “ ALEXANDRIA FERGUSON ” Practice Location

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