| Doctor Name: | DR. CHARLES LARSON ALEXANDER |
| NPI Number: | 1003859554 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | |
| Business Practice Address: | 15020 S Ravinia Ave Orland Park, IL - 604623166 |
| Business Phone Number: | 7088739059 |
| Business Fax Number: | 7084284504 |
| Mailing Address: | 19114 Jonathan Ln, HOMEWOOD |
| State: | IL |
| Postal Code: | 604304412 |
| Phone Number: | 7734573303 |
| Fax Number: | 7084284504 |
| NPI Enumeration Date: | 06/13/2006 |
| NPI Last Update Date: | 03/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |