Provider Demographics
NPI:1104322544
Name:MCCUE, ALYSSA RAE (RN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:RAE
Last Name:MCCUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1397 CRIMSON LN
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-3073
Mailing Address - Country:US
Mailing Address - Phone:630-849-5914
Mailing Address - Fax:
Practice Address - Street 1:1000 JUNGLES AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1914
Practice Address - Country:US
Practice Address - Phone:630-299-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041455085163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool