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General NPI Number Information
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NPI Number | 1366115859
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Entity Type | Individual
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Provider Name | ALEXANDRA DANIELLE WHITAKER FNP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 332 S MICHIGAN AVE OFC 8103
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City | CHICAGO
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State | IL
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Zip | 60604-4434
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Country | US
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Telephone | 815-721-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 1438 E KATIE LN
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City | PALATINE
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State | IL
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Zip | 60074-6504
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Country | US
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Telephone | 815-721-1223
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11015226
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R51555
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06212479
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License Number State | IL
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