Provider Demographics
NPI:1689942500
Name:SARTORE, ALICE MARIE (APN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MARIE
Last Name:SARTORE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22207 S GAWAIN DR
Mailing Address - Street 2:22207 SOUTH GAWAIN DRIVE
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60404-6678
Mailing Address - Country:US
Mailing Address - Phone:815-919-7431
Mailing Address - Fax:815-301-1749
Practice Address - Street 1:2055 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-1478
Practice Address - Country:US
Practice Address - Phone:630-705-1739
Practice Address - Fax:630-705-1049
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003753363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology