Healthcare Provider Details

I. General information

NPI: 1063823680
Provider Name (Legal Business Name): ALEXANDER MICHAEL NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

65 HOFF ST
SAN FRANCISCO CA
94110-1215
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4080
  • Fax:
Mailing address:
  • Phone: 414-418-9148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberA172983
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT206713
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number036146627
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: