Provider Demographics
NPI:1134744238
Name:MOREIRA, ALEXANDRA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:MOREIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W RANDOLPH ST UNIT 1004
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1433
Mailing Address - Country:US
Mailing Address - Phone:312-942-4030
Mailing Address - Fax:
Practice Address - Street 1:1150 HAMMOND DR BLDG E
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5334
Practice Address - Country:US
Practice Address - Phone:678-971-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL84522208100000X
FLME162659208D00000X
IL036168056207LP2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine