Individual
ALEXIS HUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1228 TOWANDA AVE STE 1, BLOOMINGTON, IL 61701-3469
(309) 454-5900
(309) 454-2820
Mailing address
1228 TOWANDA AVE STE 1, BLOOMINGTON, IL 61701-3469
(309) 454-5900
(309) 454-2820
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363A00000X
Physician Assistant
Primary
085.008849
IL
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
09/06/2018
Last updated
06/28/2024
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