Provider Demographics
NPI:1760006837
Name:SARKISIAN, ALEXANDRA NOEL (MS, RDN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NOEL
Last Name:SARKISIAN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 DOTY RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7509
Mailing Address - Country:US
Mailing Address - Phone:815-334-3113
Mailing Address - Fax:
Practice Address - Street 1:23640 N LOOKOUT POINTE RD
Practice Address - Street 2:
Practice Address - City:PORT BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1083
Practice Address - Country:US
Practice Address - Phone:847-769-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered