Margaret Alexis Dandridge

Key facts

NPI

1194570085

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

Practice address

315 E Rose St
Glenwood, IL 60425-1764

Phone

(773) 680-1276

NPI assigned

Apr 23, 2024

Sex

Female

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 23, 2024.

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1194570085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E ROSE ST",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251764",
            "telephone_number": "773-680-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E ROSE ST",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251764",
            "telephone_number": "773-680-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDRIDGE",
        "first_name": "MARGARET",
        "middle_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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