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General NPI Number Information
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NPI Number | 1104248806
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Entity Type | Individual
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Provider Name | ALEXANDER STEWART ROI L.C.P.C., N.C.C.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 1020 FOREST AVE
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City | WILMETTE
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State | IL
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Zip | 60091-1760
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Country | US
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Telephone | 773-965-1172
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Fax |
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Provider Business Mailing Address
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Address Line | 7022 EMERSON ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-1205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180004824
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License Number State | IL
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