Healthcare Provider Details

I. General information

NPI: 1932206729
Provider Name (Legal Business Name): MARK F ALEXANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 GRANT ST
HARVARD IL
60033-1821
US

IV. Provider business mailing address

8215 N NEWLAND AVE
NILES IL
60714-2639
US

V. Phone/Fax

Practice location:
  • Phone: 815-943-5431
  • Fax:
Mailing address:
  • Phone: 847-727-9323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: