Provider Demographics
NPI:1023054954
Name:MECCIA, ALEXANDRIA Z (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:Z
Last Name:MECCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7520 RIDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5159
Mailing Address - Country:US
Mailing Address - Phone:708-482-3213
Mailing Address - Fax:708-482-3230
Practice Address - Street 1:3253 S HARLEM AVE STE 1A
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3073
Practice Address - Country:US
Practice Address - Phone:708-788-3885
Practice Address - Fax:708-788-6884
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-090163207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-090163OtherSTATE OF ILLINOIS
IL036-090163OtherSTATE OF ILLINOIS
ILK01461Medicare ID - Type Unspecified