Provider Demographics
NPI:1942926712
Name:JOSEPH, ALEXIS (MS CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 SOUTHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1022
Mailing Address - Country:US
Mailing Address - Phone:224-766-9987
Mailing Address - Fax:
Practice Address - Street 1:2417 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2214
Practice Address - Country:US
Practice Address - Phone:847-859-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242006998235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist