Individual
ALYSA ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC, PMHNP
Contact information
Practice address
151 E BRIARCLIFF RD, BOLINGBROOK, IL 60440-3000
(630) 783-2832
Mailing address
PO BOX 27, BOLINGBROOK, IL 60440-1087
(910) 676-2227
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
209028277
IL
363LF0000X
Family Nurse Practitioner
Primary
209028277
IL
363LF0000X
Family Nurse Practitioner
9296432
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
377004192
IL
363LW0102X
Women's Health Nurse Practitioner
209028277
IL
363LW0102X
Women's Health Nurse Practitioner
9296432
FL
Other
Enumeration date
12/20/2018
Last updated
10/10/2025
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