Provider Demographics
NPI:1821530783
Name:MCFADDEN, ALANE KAE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ALANE
Middle Name:KAE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W EMPIRE ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6342
Mailing Address - Country:US
Mailing Address - Phone:815-291-8044
Mailing Address - Fax:
Practice Address - Street 1:550 WARRENVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-4311
Practice Address - Country:US
Practice Address - Phone:630-725-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily