Provider Demographics
NPI:1053883975
Name:TONIGAN, ALEXANDRIA CONSTANCE
Entity type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:CONSTANCE
Last Name:TONIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 N SOUTHPORT AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1227
Mailing Address - Country:US
Mailing Address - Phone:224-622-2855
Mailing Address - Fax:
Practice Address - Street 1:2645 N SOUTHPORT AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1227
Practice Address - Country:US
Practice Address - Phone:224-622-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist