Healthcare Provider Details

I. General information

NPI: 1013034560
Provider Name (Legal Business Name): ALEXANDER SALIM GEHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 S WOOD ST SUITE 417 CSB
CHICAGO IL
60612-4325
US

IV. Provider business mailing address

840 S WOOD ST SUITE 417 CSB
CHICAGO IL
60612-4325
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-5402
  • Fax: 312-996-2013
Mailing address:
  • Phone: 312-996-5402
  • Fax: 312-996-2013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: