Provider Demographics
NPI:1104957331
Name:SHERMAN, ALEXANDRA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALIX
Other - Middle Name:
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:618 BELLEFORTE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1626
Mailing Address - Country:US
Mailing Address - Phone:708-445-9435
Mailing Address - Fax:
Practice Address - Street 1:180 N. MICHIGAN AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7400
Practice Address - Country:US
Practice Address - Phone:312-578-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-004636103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL325270Medicare ID - Type Unspecified