Individual
MR. ALEXANDER KINGSTON CHEVALIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 351-4878
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200
(618) 529-0586
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036139252
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036139252
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.139252
ILLINOIS PHYSICIAN LICENSE
IL
Enumeration date
04/11/2012
Last updated
08/31/2021
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