Provider Demographics
NPI:1396720744
Name:POPESCU, ALEXANDRA (MD)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:
Last Name:POPESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1132 S PLYMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2008
Mailing Address - Country:US
Mailing Address - Phone:708-581-7380
Mailing Address - Fax:708-581-7385
Practice Address - Street 1:6311 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2201
Practice Address - Country:US
Practice Address - Phone:708-581-7380
Practice Address - Fax:708-581-7385
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036102438207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102438Medicaid
IL1634230OtherBCBS OF IL
IL01621679OtherBCBS OF IL
ILP00141771Medicare PIN
ILH63591Medicare UPIN
ILK06055Medicare PIN
ILIL1384002Medicare PIN