Healthcare Provider Details

I. General information

NPI: 1699485631
Provider Name (Legal Business Name): ALEXIS ADAMSICK DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N SAINT CLAIR ST STE 21-100
CHICAGO IL
60611-5970
US

IV. Provider business mailing address

675 N SAINT CLAIR ST STE 21-100
CHICAGO IL
60611-5970
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-0990
  • Fax: 312-695-1106
Mailing address:
  • Phone: 312-695-0990
  • Fax: 312-695-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209026170
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209026170
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: