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General NPI Number Information
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NPI Number | 1245042035
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Entity Type | Individual
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Provider Name | ALEXANDRA CHIATELLO LSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 127 S LIBERTY ST
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City | RUSHVILLE
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State | IL
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Zip | 62681-1419
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Country | US
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Telephone | 217-322-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 213 W SOUTH ST
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City | MT STERLING
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State | IL
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Zip | 62353-1433
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Country | US
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Telephone | 217-779-4483
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.115906
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License Number State | IL
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