Provider Demographics
NPI:1962024570
Name:MONELLI, ALLYSON GUZMAN (APRN, FNP-BC, FPA)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:GUZMAN
Last Name:MONELLI
Suffix:
Gender:F
Credentials:APRN, FNP-BC, FPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 MCARDLE DR STE D
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8149
Mailing Address - Country:US
Mailing Address - Phone:224-348-7981
Mailing Address - Fax:224-607-3302
Practice Address - Street 1:760 MCARDLE DR STE D
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8149
Practice Address - Country:US
Practice Address - Phone:847-254-6195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041420041363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner