Clarence Alexander – Driver in Crete, IL

Key facts

NPI: 1174411086
Entity type: Individual (NPI type 1)
Primary specialty: Driver 172A00000X
License: A42511272125 (IL)
Practice address: 3118 E Bending Creek TRL
Crete, IL 60417-3853
Phone: (708) 722-9450
NPI assigned: Jun 27, 2025
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
A42511272125	IL	MD	Driver

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Driver	172A00000X	A42511272125	IL	Yes

Addresses

Primary practice location

3118 E Bending Creek TRL
Crete, IL 60417-3853

Mailing address

3118 E Bending Creek TRL
Crete, IL 60417-3853
Phone (708) 722-9450

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2025.

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1174411086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 E BENDING CREEK TRL",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604173853",
            "telephone_number": "708-722-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3118 E BENDING CREEK TRL",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604173853",
            "telephone_number": "708-722-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "CLARENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IL",
            "license": "A42511272125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, IL

All providers in Crete, IL · Driver in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.