Individual provider Active NPI

Alicia L Alexander, CCC-A

  • Audiologist
  • Libertyville, IL
National Provider Identifier
1235112848
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147.001016 Issued in IL
Practice address
1512 Artaius Pkwy Ste 200
Libertyville, IL 60048-5231
Phone
(847) 573-0073
Fax
(847) 573-8660
NPI assigned
Nov 29, 2005
Last updated
May 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80827 TX
Audiologist 231H00000X 147.001016 IL Primary

Addresses

Primary practice location

1512 Artaius Pkwy Ste 200
Libertyville, IL 60048-5231

Mailing address

215 Shuman Blvd Ste 401
Naperville, IL 60563-8123
Phone (630) 303-5380

Other identifiers 1

IdentifierTypeStateIssuer
80827OtherTXSTATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
147.001016ILMDAudiologist
80827TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing, Inc. Audiologist Past Accepting new patients
Christus Trinity Clinic Texas PastSince Jan 12, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1235112848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SHUMAN BLVD STE 401",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638123",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 ARTAIUS PKWY STE 200",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485231",
            "telephone_number": "847-573-0073",
            "fax_number": "847-573-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "ALICIA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80827",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "80827",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.