Healthcare Provider Details

I. General information

NPI: 1235808890
Provider Name (Legal Business Name): ALEXANDRA CASTIGLIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S WOLF RD STE 203
WHEELING IL
60090-6524
US

IV. Provider business mailing address

5463 N NORMANDY AVE
CHICAGO IL
60656-2146
US

V. Phone/Fax

Practice location:
  • Phone: 224-313-5901
  • Fax:
Mailing address:
  • Phone: 847-826-2647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.001576
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: