Individual
ALEXANDRA BUCKWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 S HENNEPIN AVE, DIXON, IL 61021-3013
(815) 285-8520
Mailing address
102 S HENNEPIN AVE, DIXON, IL 61021-3013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125084151
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2024
Last updated
10/14/2024
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