Provider Demographics
NPI:1114094851
Name:ALEXANDER, JAMES O (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:O
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-2640
Mailing Address - Country:US
Mailing Address - Phone:618-252-0411
Mailing Address - Fax:618-252-3246
Practice Address - Street 1:901 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-2640
Practice Address - Country:US
Practice Address - Phone:618-252-0411
Practice Address - Fax:618-252-3246
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081824207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036081824Medicaid
IL036081824Medicaid
ILD94691Medicare UPIN