Healthcare Provider Details

I. General information

NPI: 1275333502
Provider Name (Legal Business Name): ALEXANDRA OLIVIA MILKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 N MAGNOLIA AVE STE 220
SANTEE CA
92071-4516
US

IV. Provider business mailing address

908 S WASHINGTON AVE
PARK RIDGE IL
60068-4811
US

V. Phone/Fax

Practice location:
  • Phone: 619-749-7059
  • Fax: 619-749-7069
Mailing address:
  • Phone: 847-651-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: