Provider Demographics
NPI:1043696966
Name:ALEXANDER, ROHSAAN
Entity type:Individual
Prefix:
First Name:ROHSAAN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 S ESCANABA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-2119
Mailing Address - Country:US
Mailing Address - Phone:773-910-2056
Mailing Address - Fax:
Practice Address - Street 1:8212 S ESCANABA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2119
Practice Address - Country:US
Practice Address - Phone:773-910-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor