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General NPI Number Information
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NPI Number | 1689609554
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Entity Type | Individual
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Provider Name | CAROL L ALEXANDER NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/07/2018
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Provider Practice Location Address
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Address Line | 7531 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60649-3954
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Country | US
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Telephone | 773-947-7500
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Fax | 773-947-7792
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Provider Business Mailing Address
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Address Line | 4988 MEADOW LAKE DR
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City | RICHTON PARK
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State | IL
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Zip | 60471-1184
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Country | US
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Telephone | 708-747-5948
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209005958
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License Number State | IL
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