Healthcare Provider Details

I. General information

NPI: 1154233344
Provider Name (Legal Business Name): ALAISIA DOMINIQUE HUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 W NATALIE LN
ADDISON IL
60101-3259
US

IV. Provider business mailing address

640 W NATALIE LN
ADDISON IL
60101-3259
US

V. Phone/Fax

Practice location:
  • Phone: 331-980-6071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: