NPIMap

Organization Active NPI

Alexandra N. Douvas

  • Dentist
  • Olympia Fields, IL
National Provider Identifier
1619484110
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019022594 Issued in IL
Legal business name
ALEXANDRA N. DOUVAS
Practice address
20180 Governors Hwy, Ste 104
Olympia Fields, IL 60461
Phone
(708) 283-2207
NPI assigned
Jan 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Authorized official

Name
Dr. Alexandra N. Douvas, DDSNPI 1639235690
Title
President
Phone
(708) 283-2207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019022594 IL Primary

Addresses

Primary practice location

20180 Governors Hwy, Ste 104
Olympia Fields, IL 60461

Mailing address

3950 N. Lake Shore Dr, Unit 430
Chicago, IL 60613
Phone (708) 283-2207

National Provider Directory

National Provider Directory

Locations

20180 Governors Hwy
Ste 104
Olympia Fields, IL 60461
Phone (708) 283-2207

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1619484110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 N. LAKE SHORE DR, UNIT 430",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "708-283-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20180 GOVERNORS HWY, STE 104",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-283-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRA N. DOUVAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "DOUVAS",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-283-2207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.