Organization
TODD D ALEXANDER MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER MARIE HAUSER (PRACTICE MANAGER)
(815) 397-0077
Entity
Organization
Contact information
Practice address
1235 N MULFORD RD, SUITE 210, ROCKFORD, IL 61107-3879
(815) 397-0077
(815) 397-0016
Mailing address
1235 N MULFORD RD, SUITE 210, ROCKFORD, IL 61107-3879
(815) 397-0077
(815) 397-0016
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036087626
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10107489
BCBS ILLINOIS
IL
01
—
DB6066
RAILROAD MEDICARE
IL
Enumeration date
02/13/2008
Last updated
02/21/2008
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