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NPI Code Detail

MEDICARE: DR. ALEXANDRIA E SCATCHELL O.D.

MEDICARE: DR. ALEXANDRIA E SCATCHELL O.D.
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
1152W00000XOptometrist046.9919IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992848071
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDRIA E SCATCHELL O.D.
Provider Business Mailing Address
First Line : 6307 N MINNEHAHA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-4120
Country : US
Telephone Number : 773-458-3230
Fax Number :
Provider Business Practice Location Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 05/10/2017

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