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Individual

JENNIFER ALEXANDRIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
351 DELNOR DR STE 200, GENEVA, IL 60134-4226
(630) 938-8850
Mailing address
351 DELNOR DRIVE STE 200, GENEVA, IL 60134
(630) 938-8850

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209010778
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN GROUP
IL
01
F400119734
MEDICARE PTAN (INDIVIDUAL)
IL
01
F400148507
MEDICARE PTAN CPG (INDIVIDUAL)
IL
01
IL5966
MEDICARE PTAN (GROUP)
IL
Enumeration date
11/02/2013
Last updated
01/22/2015
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