Alexandra Teal

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.016185 Issued in IL

Practice address

315 E Church St
Harrisburg, IL 62946-1708

Phone

(618) 253-7637

NPI assigned

Sep 12, 2022

Last updated

Sep 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1073235677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W LOCUST ST",
            "city": "GALATIA",
            "state": "IL",
            "postal_code": "629351000",
            "telephone_number": "618-499-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CHURCH ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629461708",
            "telephone_number": "618-253-7637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Bulldog Blvd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629464686",
            "country_code": "US",
            "telephone_number": "618-253-7637 x4078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 W College St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462518",
            "country_code": "US",
            "telephone_number": "618-253-7637 x4078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAL",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.016185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Harrisburg, IL
• Providers in Harrisburg, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.