Provider Demographics
NPI:1013614684
Name:CASTELLANOS, ALEJANDRA MAYTE
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:MAYTE
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-1769
Mailing Address - Country:US
Mailing Address - Phone:815-579-4855
Mailing Address - Fax:
Practice Address - Street 1:4020 E NEW YORK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4416
Practice Address - Country:US
Practice Address - Phone:331-301-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist