Healthcare Provider Details

I. General information

NPI: 1588051726
Provider Name (Legal Business Name): ALEXIS AIELLO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 E NORTH ST
CROWN POINT IN
46307-3538
US

IV. Provider business mailing address

8701 BROADWAY
MERRILLVILLE IN
46410-7035
US

V. Phone/Fax

Practice location:
  • Phone: 219-663-2793
  • Fax:
Mailing address:
  • Phone: 219-738-6670
  • Fax: 219-738-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number28220640A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28220640A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: