Provider Demographics
NPI:1033493929
Name:ARIRI, ALEX (NP)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:ARIRI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5079 LINDEN RD APT 1310
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61109-3596
Mailing Address - Country:US
Mailing Address - Phone:815-519-0417
Mailing Address - Fax:
Practice Address - Street 1:2662 ELMWOOD RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-1573
Practice Address - Country:US
Practice Address - Phone:815-639-2723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily