Alyssa Nicole Knueven, PA-C
Physician Assistant, Medical in Evergreen Park, IL. Individual provider (NPI-1).
NPI number1396192829
StatusActive
Last updated in NPPESJul 29, 2022
Details
- NPI
- 1396192829
- Entity type
- Individual (NPI-1)
- Name
- Alyssa Nicole Knueven
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 13, 2016
- Certification date
- Jul 29, 2022
- Last updated
- Jul 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 085.005827 | IL | Yes |
Practice location
3749 W 95th StEvergreen Park, IL 60805-2019
Phone 708-422-6569 · Fax 708-499-1511
Mailing address
5 N Birchwood DrNaperville, IL 60540-4073
Phone 708-653-8993
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