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General NPI Number Information
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NPI Number | 1184006397
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Entity Type | Individual
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Provider Name | MICHELE ALBA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 1600 23RD AVE
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City | GREELEY
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State | CO
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Zip | 80634-6070
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Country | US
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Telephone | 970-810-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 5359 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1450
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Country | US
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Telephone | 773-836-2785
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Fax | 773-836-7381
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R75303
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036147378
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License Number State | IL
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