Provider Demographics
NPI:1437938156
Name:KACENA, ALEXANDRA (MSN, APN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KACENA
Suffix:
Gender:F
Credentials:MSN, APN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 N LINCOLN AVE # A1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4510
Mailing Address - Country:US
Mailing Address - Phone:224-210-8064
Mailing Address - Fax:
Practice Address - Street 1:225 E CHICAGO AVE # 43
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028109363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics