Provider Demographics
NPI:1740391531
Name:ALEXANDRE, JEAN C JR (MD)
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:C
Last Name:ALEXANDRE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 7132960
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-0001
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:1870 SILVER CROSS BLVD STE 345
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-8639
Practice Address - Country:US
Practice Address - Phone:708-406-3288
Practice Address - Fax:815-462-0747
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036107083207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036107083Medicaid
ILI01534Medicare UPIN
IL036107083Medicaid