Individual
ALEXANDER JORDAN NEILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5026-23
WI
363AM0700X
Medical Physician Assistant
0010-09119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177674
—
WI
Enumeration date
06/10/2019
Last updated
02/10/2025
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