Provider Demographics
NPI:1164942850
Name:STOKOWSKI, ALEXANDER BROOKS
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:BROOKS
Last Name:STOKOWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 WATERBURY CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-3253
Mailing Address - Country:US
Mailing Address - Phone:630-585-7588
Mailing Address - Fax:
Practice Address - Street 1:2343 WATERBURY CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-3253
Practice Address - Country:US
Practice Address - Phone:630-585-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190311611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice