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NPI Code Detail

MEDICARE: ALYSSA CORRIGAN PA-C

MEDICARE: ALYSSA CORRIGAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085.007293IL

General Provider Information

NPI Number : 1255965414
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA CORRIGAN PA-C
Provider Business Mailing Address
First Line : 3000 N HALSTED ST STE 409
Second Line :
City : CHICAGO
State : IL
Zip : 60657-9268
Country : US
Telephone Number : 773-281-9200
Fax Number : 773-281-9201
Provider Business Practice Location Address
First Line : 3000 N HALSTED ST STE 409
Second Line :
City : CHICAGO
State : IL
Zip : 60657-9268
Country : US
Telephone Number : 773-281-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2020
Last Update Date : 12/09/2022

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Directions to “ ALYSSA CORRIGAN PA-C” Practice Location

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