Healthcare Provider Details

I. General information

NPI: 1154070902
Provider Name (Legal Business Name): ALEXA TAYLOR BYKOWSKI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552 S WASHINGTON ST STE 116
NAPERVILLE IL
60540-6678
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-646-7000
  • Fax: 331-221-2760
Mailing address:
  • Phone: 630-646-7000
  • Fax: 331-221-2760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016.006102
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number016006102
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016006102
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: