Provider Demographics
NPI:1366450009
Name:CIRILLI WHALEY, ALEXIS (MD)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:
Last Name:CIRILLI WHALEY
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:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-0549
Mailing Address - Country:US
Mailing Address - Phone:906-774-1313
Mailing Address - Fax:906-776-5639
Practice Address - Street 1:1711 S STEPHENSON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3639
Practice Address - Country:US
Practice Address - Phone:906-776-5800
Practice Address - Fax:906-776-5801
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088606208000000X, 2080S0012X
MT70729208000000X, 2080S0012X
AKMEDS6509208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34889600Medicaid
MI3502210752OtherBCBS OF MI
MI4907994Medicaid
MI3502210752OtherBCBS OF MI