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NPI Code Detail

MEDICARE: ALEXANDRIA CHRISTA SCODIUS

MEDICARE: ALEXANDRIA CHRISTA SCODIUS
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
1390200000XStudent in an Organized Health Care Education/Training ProgramIL

General Provider Information

NPI Number : 1073459954
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA CHRISTA SCODIUS
Provider Business Mailing Address
First Line : 929 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4408
Country : US
Telephone Number : 312-530-0323
Fax Number :
Provider Business Practice Location Address
First Line : 929 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4408
Country : US
Telephone Number : 312-530-0323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2026
Last Update Date : 04/29/2026

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Directions to “ ALEXANDRIA CHRISTA SCODIUS ” Practice Location

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