Provider Demographics
NPI:1730589045
Name:SOLIS, ALICE (QMHP)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 W 25TH ST UNIT 1751
Mailing Address - Street 2:
Mailing Address - City:NORTH RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-2930
Mailing Address - Country:US
Mailing Address - Phone:414-367-7223
Mailing Address - Fax:
Practice Address - Street 1:1800 SCOVILLE AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-1908
Practice Address - Country:US
Practice Address - Phone:414-367-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional