Healthcare Provider Details

I. General information

NPI: 1558173385
Provider Name (Legal Business Name): AALIYAH GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 CHARIOT LN
OLYMPIA FIELDS IL
60461-1514
US

IV. Provider business mailing address

2737 CHARIOT LN
OLYMPIA FIELDS IL
60461-1514
US

V. Phone/Fax

Practice location:
  • Phone: 630-538-5587
  • Fax:
Mailing address:
  • Phone: 630-538-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: