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NPI Code Detail

MEDICARE: ALEXANDRA STARK

MEDICARE: ALEXANDRA STARK
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
1106S00000XBehavior TechnicianRBT-21-154884IL

General Provider Information

NPI Number : 1356200067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA STARK
Provider Business Mailing Address
First Line : 2400 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3936
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2400 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3936
Country : US
Telephone Number : 773-389-2202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 02/04/2026

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Directions to “ ALEXANDRA STARK ” Practice Location

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