Basic Information
| Provider Information | |||||||||
| NPI: | 1265526040 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INGRID I. ALEXANDER, MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 W. MILLER ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2177890668 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2901OLD JACKSONVILLE ROAD | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2176979722 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ALEXANDER | ||||||||
| AuthorizedOfficialFirstName: | INGRID | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 2176989722 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.