Organization
JOHN ALEXANDER ISRAEL CONSULTING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L FREEZE (PRACTICE ADMINISTRATOR)
(219) 926-8320
Entity
Organization
Contact information
Practice address
1401 S WOODLAND AVE STE 3, MICHIGAN CITY, IN 46360-7189
(219) 877-4758
Mailing address
PO BOX 2257, CHESTERTON, IN 46304-0357
(219) 926-8320
(219) 926-3524
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042094A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522563
ANTHEM
IN
Enumeration date
06/30/2009
Last updated
02/03/2025
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