Individual
DR. ALEXANDER ETHAN FELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19110 DARVIN DR, MOKENA, IL 60448-8595
(708) 478-8889
Mailing address
PO BOX 476705, CHICAGO, IL 60647-6705
(773) 307-8659
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932287
BCBS
IL
01
—
P00184861
RAILROAD MEDICARE
IL
Enumeration date
07/11/2006
Last updated
11/08/2007
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