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NPI Code Detail

MEDICARE: MS. VELINDA DENISE ALEXANDER

MEDICARE: MS. VELINDA DENISE 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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1720322480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VELINDA DENISE ALEXANDER
Provider Business Mailing Address
First Line : 1201 E 172ND ST
Second Line :
City : SOUTH HOLLAND
State : IL
Zip : 60473-3568
Country : US
Telephone Number : 773-374-7046
Fax Number : 773-374-7053
Provider Business Practice Location Address
First Line : 1712 E 87TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-2740
Country : US
Telephone Number : 773-374-7046
Fax Number : 773-374-7053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2012
Last Update Date : 11/19/2012

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