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NPI Code Detail

MEDICARE: SHERELL L ALEXANDER

MEDICARE: SHERELL L ALEXANDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianIL

General Provider Information

NPI Number : 1073384046
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERELL L ALEXANDER
Provider Business Mailing Address
First Line : 1939 GROVE AVE APT 203
Second Line :
City : BERWYN
State : IL
Zip : 60402-1761
Country : US
Telephone Number : 773-812-1098
Fax Number :
Provider Business Practice Location Address
First Line : 737 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2539
Country : US
Telephone Number : 773-672-9815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/09/2024

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Directions to “ SHERELL L ALEXANDER ” Practice Location

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