Provider Demographics
NPI:1114421286
Name:HANRAHAN, ALEXANDRA MC QUATTIE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MC QUATTIE
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:MCQUATTIE-PIMENTEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1000 S CLARK ST UNIT 2507
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2197
Mailing Address - Country:US
Mailing Address - Phone:312-241-7071
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3055
Practice Address - Country:US
Practice Address - Phone:312-926-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.072503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine