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General NPI Number Information
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NPI Number | 1295105484
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Entity Type | Individual
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Provider Name | ALISON ELAINE BURCHARDT APN
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 1890 SILVER CROSS BOULEVARD PAVILION A, SUITE 240
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City | NEW LENOX
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State | IL
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Zip | 60451
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Country | US
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Telephone | 815-740-1900
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Fax | 815-485-4458
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Provider Business Mailing Address
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Address Line | 2025 S CHICAGO ST STE 1
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City | JOLIET
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State | IL
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Zip | 60436-3173
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Country | US
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Telephone | 815-726-2200
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209013337
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209013337
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License Number State | IL
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