Physician Compare National (NPI:1285942755)

HEALTHCARE PROVIDER: ALICE MARGARET VANDECAVEYE LISW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1285942755
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072868264
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180611002968
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VANDECAVEYE
	Individual professional last name
Provider First Name	ALICE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5800 MONROE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 2
	Group Practice or individual's line 2 address
City	SYLVANIA
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	435602263
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4192760117
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360048
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY OF TOLEDO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y