Provider Demographics
NPI:1306250303
Name:GIAMMANCO, ALEXANDRA DANEKAS (SPEECH-LANGUAGE PATH)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:DANEKAS
Last Name:GIAMMANCO
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:THERESE
Other - Last Name:DANEKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1640 N WELLS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6087
Mailing Address - Country:US
Mailing Address - Phone:312-642-4300
Mailing Address - Fax:312-642-4302
Practice Address - Street 1:1640 N WELLS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6087
Practice Address - Country:US
Practice Address - Phone:312-642-4300
Practice Address - Fax:312-642-4302
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist