Basic Information
| Provider Information | |||||||||
| NPI: | 1861928491 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURK | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | N. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | CNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DOWNS | ||||||||
| OtherFirstName: | ALEXIS | ||||||||
| OtherMiddleName: | N | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 525 E GRANT ST | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | IL | ||||||||
| PostalCode: | 614553313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3098361542 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 320 N MADISON ST | ||||||||
| Address2: | |||||||||
| City: | PITTSFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2172859601 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2017 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 041412824 | IL | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 209016145 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.