Provider Demographics
NPI:1245223098
Name:ALEXANDER, JONATHAN M (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:M
Last Name:ALEXANDER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9600 GROSS POINT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1214
Mailing Address - Country:US
Mailing Address - Phone:847-933-6111
Mailing Address - Fax:847-933-6113
Practice Address - Street 1:9600 GROSS POINT RD
Practice Address - Street 2:SUITE A
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1214
Practice Address - Country:US
Practice Address - Phone:847-933-6111
Practice Address - Fax:847-933-6113
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2021-12-29
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Provider Licenses
StateLicense IDTaxonomies
IL0360802582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF55207Medicare UPIN