Provider Demographics
NPI:1881982866
Name:ALLIANCE HEALTHCARE PROVIDERS, INC.
Entity type:Organization
Organization Name:ALLIANCE HEALTHCARE PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, PCCN,APRN
Authorized Official - Phone:630-508-0891
Mailing Address - Street 1:2189 ASHBY LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5443
Mailing Address - Country:US
Mailing Address - Phone:630-508-0891
Mailing Address - Fax:630-485-6975
Practice Address - Street 1:2189 ASHBY LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-5443
Practice Address - Country:US
Practice Address - Phone:630-508-0891
Practice Address - Fax:630-485-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004954363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1073846440OtherNPPES