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General NPI Number Information
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NPI Number | 1720883127
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Entity Type | Individual
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Provider Name | ALEXANDRA AYLWARD
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1 157 CTR
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3657
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Country | US
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Telephone | 618-352-1832
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Fax | 630-216-6222
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Provider Business Mailing Address
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Address Line | 2310 MONTICELLO PL
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-8006
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Country | US
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Telephone | 618-352-1832
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Fax | 630-216-6222
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 3002706
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License Number State | IL
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