Provider Demographics
NPI:1982156485
Name:CLAPSADDLE, ALLYSSA JEAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSSA
Middle Name:JEAN
Last Name:CLAPSADDLE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1240 N MILWAUKEE AVE STE A
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1307
Practice Address - Country:US
Practice Address - Phone:847-367-5575
Practice Address - Fax:847-367-5579
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2023-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085.005983363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant