Provider Demographics
NPI:1457028177
Name:LYEWSKI, ALEXANDRA NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:LYEWSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 W 95TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2300
Mailing Address - Country:US
Mailing Address - Phone:708-425-0112
Mailing Address - Fax:708-425-2785
Practice Address - Street 1:5660 W 95TH ST STE 4
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2300
Practice Address - Country:US
Practice Address - Phone:708-425-0112
Practice Address - Fax:708-425-2785
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily