| Doctor Name: | MS. ALICA KELLY BARTLETT |
| NPI Number: | 1306836697 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 561349 |
| Business Practice Address: | 1020 11th Ave Great Lakes, IL - 600883102 |
| Business Phone Number: | 8476885568 |
| Business Fax Number: | 8476884413 |
| Mailing Address: | 4298 New Haven Ave, GURNEE |
| State: | IL |
| Postal Code: | 600315805 |
| Phone Number: | 8476885568 |
| Fax Number: | 8476884413 |
| NPI Enumeration Date: | 10/27/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 561349 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |