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NPI Code Detail

MEDICARE: ALEXIS V ANDERSON PT

MEDICARE: ALEXIS V ANDERSON PT
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
1225100000XPhysical Therapist070.023078IL

General Provider Information

NPI Number : 1730606542
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS V ANDERSON PT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1077 E GOLF RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4271
Country : US
Telephone Number : 847-305-1400
Fax Number : 847-305-1556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 03/10/2026

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