Provider Demographics
NPI:1275930414
Name:KIOUTAS, ALLISON CATHERINE (AGNP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CATHERINE
Last Name:KIOUTAS
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CATHERINE
Other - Last Name:SILCROFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, AGNP-C
Mailing Address - Street 1:25 N WINFIELD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-232-0280
Mailing Address - Fax:630-232-3895
Practice Address - Street 1:25 N WINFIELD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-232-0280
Practice Address - Fax:630-232-3895
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012254363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner