Provider Demographics
NPI:1508645037
Name:BANCOLITA, ALEXIS MANLANGIT (RN)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:MANLANGIT
Last Name:BANCOLITA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SAINT JOHNS AVE UNIT 303
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5215
Mailing Address - Country:US
Mailing Address - Phone:312-550-4322
Mailing Address - Fax:
Practice Address - Street 1:333 PFINGSTEN RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2002
Practice Address - Country:US
Practice Address - Phone:847-272-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041408702163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse