MEDICARE: ALEXANDER JOSHUA SCHWANINGER

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
1	101YP2500X	Professional Counselor	180011236	IL

General Provider Information

NPI Number	:	1518190073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER JOSHUA SCHWANINGER

Provider Business Mailing Address
First Line	:	401 W WEBSTER AVE APT 409
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3844
Country	:	US
Telephone Number	:	312-572-9581
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 W MONROE ST STE 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-4955
Country	:	US
Telephone Number	:	312-572-9581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2009
Last Update Date	:	01/18/2018

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