Provider Demographics
NPI:1689972341
Name:FOX, ALEXANDRA (LCPC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 N ASTOR ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2114
Mailing Address - Country:US
Mailing Address - Phone:312-972-3666
Mailing Address - Fax:312-335-8795
Practice Address - Street 1:500 N MICHIGAN AVE STE 2020
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3791
Practice Address - Country:US
Practice Address - Phone:312-972-3666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007685101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional