Individual
INGRID I ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2901 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7437
(217) 698-9722
(217) 391-0392
Mailing address
2901 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7437
(217) 670-2424
(217) 670-2809
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036062338
IL
2080P0201X
Pediatric Allergy/Immunology Physician
036062338
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020057300
BLACK LUNG
IL
01
—
036062338
IL STATE LICENSE
IL
05
—
036062338
—
IL
01
—
08421024
BC/BS
IL
01
—
109819
HEALTHLINK
IL
01
—
133586700
ACS-OWCP
IL
01
—
14D0949277
CLIA
IL
01
—
310033
PERSONAL CARE
IL
01
—
CD7143
RR MEDICARE GROUP
IL
Enumeration date
06/04/2006
Last updated
09/24/2014
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