Provider Demographics
NPI:1730632316
Name:LEONOVA, ALENA V (APN NP-C)
Entity type:Individual
Prefix:MISS
First Name:ALENA
Middle Name:V
Last Name:LEONOVA
Suffix:
Gender:F
Credentials:APN NP-C
Other - Prefix:MISS
Other - First Name:ALENA
Other - Middle Name:
Other - Last Name:LIAONAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1331 W 75TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9336
Mailing Address - Country:US
Mailing Address - Phone:630-652-0606
Mailing Address - Fax:
Practice Address - Street 1:1331 W 75TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9336
Practice Address - Country:US
Practice Address - Phone:630-652-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014616363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily