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NPI Code Detail

MEDICARE: CARMEN ALYCE PRATER-BELLVER PA-C

MEDICARE: CARMEN ALYCE PRATER-BELLVER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085011682IL

General Provider Information

NPI Number : 1063304301
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN ALYCE PRATER-BELLVER PA-C
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 2320 E 93RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-3909
Country : US
Telephone Number : 773-967-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2025
Last Update Date : 01/12/2026

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Directions to “ CARMEN ALYCE PRATER-BELLVER PA-C” Practice Location

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