Provider Demographics
NPI:1194373662
Name:MONSIVAIS, ALYSSA M (APN-CNM)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:MONSIVAIS
Suffix:
Gender:F
Credentials:APN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:4400 W 95TH ST STE 207
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2658
Practice Address - Country:US
Practice Address - Phone:708-684-4636
Practice Address - Fax:708-684-3045
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019941367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife