Provider Demographics
NPI:1679701569
Name:ALEXANDER, KARINA AMELIA (DO)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:AMELIA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-2000
Mailing Address - Fax:
Practice Address - Street 1:28381 DAVIS PKWY STE 700
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3033
Practice Address - Country:US
Practice Address - Phone:630-348-3000
Practice Address - Fax:630-836-0565
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036141108208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036141108Medicaid