Sandra Alexandria, DC
Individual provider Active NPI Chiropractor · Chicago, IL
NPI 1285872598 · NPPES record last updated Jun 9, 2016
Key facts
- NPI
- 1285872598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038012976 (IL)
- Practice address
- 641 W Grand Ave
Chicago, IL 60654-6785 - Phone
- (312) 898-6327
- NPI assigned
- Jan 23, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231122002270 | IL | Practitioner - Chiropractic | 7719335272 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227001037 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Neuro & Physical Rehabilitation LTD | Chiropractor | Current |
Accepting new patients |
| Premise Health of Illinois Medical PC | Current |
Accepting new patients | |
| Premise Health of Illinois Medical PC | Current | 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
Ste 106
Wood Dale, IL 60191
Phone (630) 766-1552
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227001037 | IL | |
| Chiropractor | 111N00000X | 038012976 | IL | Yes |
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
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.