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NPI Code Detail

MEDICARE: ALYSSA SUZANNE KAMPEN

MEDICARE:   ALYSSA SUZANNE KAMPEN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1396538492
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA SUZANNE KAMPEN
Provider Business Mailing Address
First Line : 1775 BALLARD RD FL 2
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-1005
Country : US
Telephone Number : 847-318-6020
Fax Number :
Provider Business Practice Location Address
First Line : 1775 BALLARD RD FL 2
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-1005
Country : US
Telephone Number : 847-318-6020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2025
Last Update Date : 05/18/2026

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Directions to “ ALYSSA SUZANNE KAMPEN ” Practice Location

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