Provider Demographics
NPI:1407651854
Name:MASHAL, ALA'A (FNP)
Entity type:Individual
Prefix:
First Name:ALA'A
Middle Name:
Last Name:MASHAL
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13550 S ROUTE 30 STE 100
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5686
Mailing Address - Country:US
Mailing Address - Phone:815-436-1655
Mailing Address - Fax:
Practice Address - Street 1:13550 S ROUTE 30 STE 100
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5686
Practice Address - Country:US
Practice Address - Phone:815-436-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily