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Individual

AILENE ALLY ELIZABETH WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
10209 W LINCOLN HWY, FRANKFORT, IL 60423-1279
(708) 998-2979
(708) 273-5531
Mailing address
522 GODFREY LN, AUBURN, AL 36830-6018
(205) 362-5535

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010429
IL
363A00000X
Physician Assistant
12087
GA
363A00000X
Physician Assistant

Other

Enumeration date
10/16/2023
Last updated
05/21/2024
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