Individual
ALEXANDRA INCANDELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Mailing address
6962 CAMBRIA CV, VILLAGE OF LAKEWOOD, IL 60014-6652
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.006003
IL
390200000X
Student in an Organized Health Care Education/Training Program
135.001068
IL
Other
Enumeration date
08/26/2019
Last updated
03/28/2023
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