Healthcare Provider Details

I. General information

NPI: 1184487951
Provider Name (Legal Business Name): ANAYELIT ALCAIDE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 HEALTHWAY DR
AURORA IL
60504-8183
US

IV. Provider business mailing address

4050 HEALTHWAY DR
AURORA IL
60504-8183
US

V. Phone/Fax

Practice location:
  • Phone: 815-409-5117
  • Fax:
Mailing address:
  • Phone: 815-409-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150.112901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: