Healthcare Provider Details

I. General information

NPI: 1487520938
Provider Name (Legal Business Name): ALEXIS MARIA SKORDILIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6428 JOLIET RD
COUNTRYSIDE IL
60525-4646
US

IV. Provider business mailing address

422 W MELROSE ST APT 403
CHICAGO IL
60657-3836
US

V. Phone/Fax

Practice location:
  • Phone: 877-937-4744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: