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General NPI Number Information
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NPI Number | 1508186826
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Entity Type | Individual
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Provider Name | ALEXANDRA SULIK NP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 300 VILLAGE CIR UNIT A
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1812
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Country | US
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Telephone | 815-988-8100
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Fax | 779-210-4583
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Provider Business Mailing Address
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Address Line | 300 VILLAGE CIR UNIT A
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1812
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Country | US
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Telephone | 815-708-0382
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Fax | 779-210-4583
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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 | 209.008166
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 277000004
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License Number State | IL
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