Provider Demographics
NPI:1871046664
Name:ILCHENA, ALESANDRA NADIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALESANDRA
Middle Name:NADIA
Last Name:ILCHENA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 BALLANTYNE ST
Mailing Address - Street 2:2
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3795
Mailing Address - Country:US
Mailing Address - Phone:630-209-7222
Mailing Address - Fax:
Practice Address - Street 1:746 S MAIN AVE
Practice Address - Street 2:STE D
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3333
Practice Address - Country:US
Practice Address - Phone:760-728-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor