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General NPI Number Information
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NPI Number | 1407273774
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Entity Type | Individual
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Provider Name | ALYSSA CEILESH D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 5666 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-2425
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Country | US
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Telephone | 815-977-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 5666 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-2425
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Country | US
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Telephone | 815-977-4123
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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 | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 036143661
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036143661
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.064587
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License Number State | IL
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