Individual provider Active NPI

Sandra Alexandria, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1285872598
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012976 Issued in IL
Practice address
641 W Grand Ave
Chicago, IL 60654-6785
Phone
(312) 898-6327
NPI assigned
Jan 23, 2009
Last updated
Jun 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227001037 IL
Chiropractor 111N00000X 038012976 IL Primary

Addresses

Primary practice location

641 W Grand Ave
Chicago, IL 60654-6785

Mailing address

1008 Concord Dr
Bartlett, IL 60103-5704
Phone (630) 640-6346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122002270 IL Practitioner - Chiropractic 7719335272 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012976ILMDChiropractor
227001037ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Neuro & Physical Rehabilitation LTD Chiropractor CurrentSince Nov 1, 2023 Accepting new patients
Premise Health of Illinois Medical PC CurrentSince Mar 10, 2024 Accepting new patients
Premise Health of Illinois Medical PC CurrentSince Mar 10, 2024 Accepting new patients
Premise Health of Illinois Medical PC Current Accepting new patients
Neurologic Wellness Institute PLLC Past Accepting new patients

Locations

16906 Collection Ctr Dr
Chicago, IL 60693

4979 Indiana Ave
Lisle, IL 60532
Phone (312) 337-4150

199 S Addison Rd
Wood Dale, IL 60191
Phone (630) 766-1552

199 S Addison Rd
#105106
Wood Dale, IL 60191
Phone (630) 766-1552

199 S Addison Rd
Ste 106
Wood Dale, IL 60191
Phone (630) 766-1552

Organizations & group practices 5

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": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1285872598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 CONCORD DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601035704",
            "telephone_number": "630-640-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546785",
            "telephone_number": "312-898-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDRIA",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227001037",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.