Individual provider · Type 1 NPI

Alyssa Brie Ketchum, PA-C

Surgical Physician Assistant · Chicago, IL

NPI number 1104200625 Active

Practice location

676 N Saint Clair St Ste 1900
Chicago, IL 60611-2986

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085005549 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1104200625

Alyssa Brie Ketchum, PA-C's National Provider Identifier is 1104200625, issued on Jul 14, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Chicago, IL. The record was last updated on Dec 17, 2018.