Individual provider · NPI-1

Alysa Angel, APRN, FNP-BC, PMHNP

Nurse Practitioner, Family · Bolingbrook, IL

NPI number1780156281
StatusActive
Last updated in NPPESOct 10, 2025

Details

NPI
1780156281
Entity type
Individual (NPI-1)
Name
Alysa Angel
Credential
APRN, FNP-BC, PMHNP
Sex
Female
Sole proprietor
No
Enumeration date
Dec 20, 2018
Certification date
Oct 10, 2025
Last updated
Oct 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family209028277ILYes
171000000X Military Health Care Provider209028277IL
363LW0102X Nurse Practitioner, Women's Health209028277IL
363LP0808X Nurse Practitioner, Psych/Mental Health377004192IL
363LW0102X Nurse Practitioner, Women's Health9296432FL
363LF0000X Nurse Practitioner, Family9296432FL

Practice location

151 E Briarcliff Rd
Bolingbrook, IL 60440-3000

Phone 630-783-2832

Mailing address

Po Box 27
Bolingbrook, IL 60440-1087

Phone 910-676-2227

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