Individual
ALEXANDER DAVID RAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 W WALNUT ST BLDG 3, JACKSONVILLE, IL 62650-1136
(217) 243-8455
(217) 243-7951
Mailing address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 243-8455
(217) 243-7951
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-144397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-144397
STATE LICENSE
IL
Enumeration date
06/27/2013
Last updated
12/09/2020
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