Individual
ALEXANDER J. ALONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036115179
IL
207RH0005X
Hypertension Specialist Physician
036115179
IL
207RN0300X
Nephrology Physician
Primary
036115179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115179
—
IL
01
—
CA4079
RR GROUP
IL
01
—
P00414412
RR INDIVIDUAL
IL
Enumeration date
03/15/2007
Last updated
01/16/2025
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