Active NPI
Alyssa Fulton
- Social Worker
- Gurnee, IL
National Provider Identifier
1609695733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150118870
- Practice address
- 5465 Grand Ave Ste 101
Gurnee, IL 60031-4913 - Phone
- (224) 303-4395
- NPI assigned
- Oct 7, 2024
- Last updated
- Jan 5, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150118870 | IL | Primary |
Addresses
Primary practice location
5465 Grand Ave Ste 101
Gurnee, IL 60031-4913
Mailing address
100 Malton Rd
Negaunee, MI 49866-2001
Phone (906) 228-9699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150118870 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767571200000",
"number": "1609695733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MALTON RD",
"city": "NEGAUNEE",
"state": "MI",
"postal_code": "498662001",
"telephone_number": "906-228-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5465 GRAND AVE STE 101",
"city": "GURNEE",
"state": "IL",
"postal_code": "600314913",
"telephone_number": "224-303-4395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-07",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150118870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurnee, IL
- Mark E Fredrick, DC
- Sarah Rose French-Villarreal
- Fresenius Medical Care Lake County, LLC (Fresenius Medical Care Gurnee)
- Walter I Fried, PH.D., M.D.
- Lisa Lois Fuechtmann, LCPC
- Future Sleep Solutions
- Fyzical Gurnee Clinical PLLC
- Dante Polintan Gabriel, MD
- Tammy B. Gaile, CCC-SLP/L
- Timothy Joseph Gaither, LPC, NCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.