Individual provider Active NPI

Alexandra Bone

  • Dentist
  • Great Lakes, IL
National Provider Identifier
1174443790
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.037082 Issued in IL
Practice address
3440 Ohio St
Great Lakes, IL 60088-3155
Phone
(224) 610-8551
NPI assigned
Jul 16, 2026
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.037082 IL Primary

Addresses

Primary practice location

3440 Ohio St
Great Lakes, IL 60088-3155

Mailing address

30027 N Waukegan Rd Apt 116
Lake Bluff, IL 60044-1090

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1174443790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30027 N WAUKEGAN RD APT 116",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 OHIO ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883155",
            "telephone_number": "224-610-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONE",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.037082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.