Provider Demographics
NPI:1053787630
Name:NALEWAY, AIMEE (PA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:NALEWAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:AMBROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:630-315-6865
Practice Address - Street 1:4003 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5802
Practice Address - Country:US
Practice Address - Phone:888-693-6437
Practice Address - Fax:630-432-6667
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005656363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400250991OtherMEDICARE PTAN INDIVIDUAL
IL920540OtherMEDICARE PTAN GROUP
IL920540OtherMEDICARE PTAN GROUP