Provider Demographics
NPI:1720322480
Name:ALEXANDER, VELINDA DENISE
Entity Type:Individual
Prefix:MS
First Name:VELINDA
Middle Name:DENISE
Last Name:ALEXANDER
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 1:1201 E 172ND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-3568
Mailing Address - Country:US
Mailing Address - Phone:773-374-7046
Mailing Address - Fax:773-374-7053
Practice Address - Street 1:1712 E 87TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2740
Practice Address - Country:US
Practice Address - Phone:773-374-7046
Practice Address - Fax:773-374-7053
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist