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Organization

AXIAL FROST CLINIC IL PC

Active
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Organization

AXIAL FROST CLINIC IL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALICE HEYWOOD (CHIEF LEGAL OFFICER)
(615) 231-8560
Entity
Organization

Contact information

Practice address
25 E WASHINGTON ST STE 1615, CHICAGO, IL 60602-1882
(615) 345-3555
Mailing address
209 10TH AVE S STE 350, NASHVILLE, TN 37203-4166
(615) 345-3555

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—

Other

Enumeration date
07/16/2025
Last updated
09/30/2025
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